Medicare Annual Wellness Equals Prevention

Medicare Annual Wellness Visit

Medicare Annual Wellness Visit

Medicare Annual Wellness Visit (AWV) is a yearly appointment with your primary care provider (PCP) to develop or update your personalized prevention plan. The AWV helps you prevent disease and disability based on your current health and risk factors.

Annual Wellness Visit is FREE

medicare annual wellness visit

Medicare will pay for your Annual Wellness Visit (AWV) when the following is true:

  • It have been 12 months or longer since your last AWV. Otherwise,12 months since your Initial AWV also called Welcome to Medicare Visit
  • During this 12 month period you have had Medicare Part B

If you qualify, Medicare Part B covers your AWV at 100% of the Medicare-approved cost. Moreover, there is $0 deductible. So you do not pay the $198 Part B deductible in 2020. Therefore, you pay nothing (no deductible and no coinsurance).

However, if you AWV uncovers the need to investigate or treat a new or existing problem, Medicare may bill you for any diagnostic care.

Your First Annual Wellness Visit

Your first AWV maybe your Welcome to Medicare Visit if it occurs within the first 12 months of enrolling in Medicare Part B. During your initial visit, your primary care physician will cover the following:

Health Risk Assessment – you fill out the form show on the right. The health assessment includes the following:

  1. General HealthTobacco and Alcohol Use
  2. Nutrition
  3. Physical Activity
  4. Sleep
  5. Functional Status Assessment
  6. Pain Assessment
  7. Home/Safety
  8. Depression

Provider Consultation – reviews your Health Risk Assessment and addresses the following:

  • Psychosocial risks
  • Behavioral risks
  • Activities of Daily Living
  • Establish list of current providers and suppliers
  • Establish your medical/social and family history
  • Physical Exam includes your height, weight, body mass index, blood pressure, visual acuity, and other factors based on your assessment
  • Establish or detect any cognitive impairment you may have

Personalized Prevention Plan – a list of risk factors and conditions for which primary, secondary, and tertiary interventions are recommended. In addition, you will be furnished personalized health advice and referrals, as appropriate, to health education or preventive counseling services or programs such as:

  • Alcohol misuse counseling
  • Obesity counseling
  • Tobacco use cessation counseling
medicare annual wellness visit health risk assessment
visual acuity testing
medicare annual wellness visit AWV

Your Subsequent Annual Wellness Visits

After your initial AWV, you can follow-up for FREE every 12 months. Health conditions changer over time. Therefore, it is in your best interest to visit your primary care physician on an annual basis. Here is what you can expect during your subsequent AWV:

  • You can update your medical/family history
  • In addition, you can update the list of current providers and suppliers who provide you with medical care.
  • Check your weight (or waist circumference), blood pressure, and other routine measurements
  • Detection of any cognitive impairment
  • Updates to your personalized prevention plan
  • Receive personalized health advice and referrals to health education, preventive counseling, and programs

How to Make An Annual Wellness Appointment

The Washington Post published an article about a lady on Medicare named Beverly Dune. She, “called her primary care doctor’s office to schedule an annual checkup, she assumed her Medicare coverage would pick up most of the tab. The appointment seemed like a routine physical, and she was pleased that the doctor spent a lot of time with her. Until she got the bill: $400.”

It is very important that when you call your doctor to make an appointment use the words, “annual wellness visit.” Otherwise, if you use the words, “Annual Physical” the visit can cost you $400! A physical exam is more comprehensive than a wellness visit. For example, a physical is a full-body examination where the doctor exams your head, neck, lungs, abs, reflexes and neurological responses. In addition, physicals usually include blood and urine lab testing. Therefore, make sure you use the words “annual wellness visit” when you schedule your doctor’s appointment.