A Medicare Annual Wellness Visit is a preventative service in which you and your PCP—doctor (MD), nurse practitioner (APRN), or physician assistant (PA)—will gather health information and advise you on how to maintain or improve your health. The conversation will focus on your medical history, family medical history, risk for certain diseases, current health, and immunization status. Your provider will work with you to make a personalized health plan. They may order health screenings, such as appropriate cancer screenings or bloodwork related to your current conditions.

The Medicare Annual Wellness Visit is a free yearly appointment with your PCP that focuses on wellness and disease prevention. This appointment is not a physical but a conversation between you and your PCP to discuss your health history and any concerns you may have regarding your health. This appointment is generally longer than a routine follow-up visit, allowing you the time to have a meaningful conversation with your PCP about your health risks and needs.

During the Annual Wellness Visit, your provider will check your height, weight, blood pressure, and other measurements, review your medications and immunizations, and order any screenings or bloodwork related to your current medical conditions. Your medical and family history will be updated, and a health risk assessment will be completed. The goals of the Annual Wellness Visit are to create a complete personal and family health history and to prevent future health problems.

A physical includes a hands-on head-to-toe assessment of your major body systems and often focuses on your current illness or chronic conditions. Medicare covers the Medicare Initial Preventive Physical Exam (IPPE), which is similar to the physical visit format, within the first 12 months of your enrollment into Medicare. Physicals are not covered after your first 12 months as a Medicare member. Annual Wellness Visits are covered every year.

An Annual Wellness visit is not:

• To diagnose or treat new problems.
• For if you are not feeling well or are concerned about a medical problem. We would want to schedule a follow-up visit.
• A physical examination.

Medicare provides a range of coverage options for provider visits, treatments, and testing. If you’re unsure about your specific benefits and would like to know more about your options, call the member services phone number on the back of your insurance card.

The IPPE is also known as your “Welcome to Medicare” visit. This benefit is covered for new Medicare patients within 12 months of the first Part B coverage period. At this visit, your medical and social health history and preventive services education will be reviewed. There is one IPPE per lifetime.

You cannot receive your Annual Wellness Visit within the same year as your IPPE/Welcome to Medicare Visit.

The research has shown that people with Medicare who have an Annual Wellness Visit are more likely to receive important preventive care services such as vaccines and cancer screenings than those who skip the visit. It’s also a great way to get personalized advice that can lower the risk of diseases like cancer or help manage any current chronic conditions, like diabetes or high blood pressure, in a way that is tailored specifically to you and your needs.

Original Medicare (Medicare Part B) or Medicare Advantage members enrolled for 12 months and have not had their “Welcome to Medicare” visit in the last 12 months are eligible for the Annual Wellness Visits.

Your first yearly “Wellness” visit can’t occur within 12 months of your Part B enrollment or your “Welcome to Medicare” preventive visit. However, you don’t need a “Welcome to Medicare” preventive visit to qualify for a yearly “Wellness” visit.

• A list of your medications (pills, inhalers, patches, eye drops, etc.), including any over-the-counter drugs, vitamins, and supplements.
• A list of all your health care providers, including specialist doctors, nurse practitioners, physician assistants, pharmacists, and therapists.
• A record of your immunizations, including flu, COVID-19, and pneumonia.
• Name of the home health agency you may be involved with.
• Names of medical supply companies you currently use (e.g., oxygen, medical equipment, etc.)
• Names and locations of pharmacies you use.

An Annual Wellness Visit is included with Medicare Part B coverage and Medicare Advantage Plans.

• A copay may be required for screening or diagnostic tests that may be ordered.
• A copay may be required for services provided that are not included during this preventative visit.

If you have questions about what is covered, call the member services number on the back of your Medicare insurance card or review their website.

This is very specific to your Medicare insurance plan. Some Medicare Advantage Plans allow your Annual Wellness Visit to be scheduled anytime in the year, whereas others require it to be scheduled after a full year or 366 days from your last Annual Wellness Visit. It’s good practice to call the member services number on your insurance card and ask them for the timeframe for scheduling your Annual Wellness Visit.