What is a Medicare Wellness Visit?

Posted on October 3, 2024 By Jeff Snyder

You may have heard of wellness visits, especially if you’re enrolled in Medicare Part B. If you’re one of the 68 percent of eligible seniors who haven’t heard of them or just don’t know what they entail, keep reading. We’ll tell you why you should take advantage of any of these valuable visits if you’re eligible for them.

Welcome to Medicare Visit

When you first enroll in Medicare Part B, you’re eligible for a Welcome to Medicare wellness visit with a doctor. This visit is an important step in figuring out how you can stay healthy.

During the examination, your doctor will get a general overview of your medical and family history, as well as give you a few tests and screenings. He or she will use this information to determine a plan for care and provide you with a checklist of free medical and preventative screenings available to you.

When you have your visit, be sure to bring your in-depth medical records and family medical history. Even if you’re meeting with your primary care physician, the more information you can provide, the better. You should also bring any medications, vitamins, or supplements you’re currently taking, including over-the-counter drugs. Tell your doctor how often you take them and why.

One thing to note is that your Welcome to Medicare visit is only available within the first 12 months you’re enrolled in Part B. Once you’re outside of this window, you’ll need to wait for an annual wellness visit.

Annual Wellness Visit

The Annual Wellness visit is available to anyone enrolled in Part B longer than 12 months. You’re only eligible for this visit once every 12 months, after 11 full months have passed since your previous visit.

This visit is used to update your personal wellness plan and act as a preventative care meeting. Your health care provider will also request that you fill out a “Health Risk Assessment” — a questionnaire designed to develop or update your illness prevention plan.

Much like your Welcome to Medicare visit, the Annual Wellness visit will review your medical and family history and update health measurements like your height, weight, and blood pressure. During your meeting, your doctor will cover any risk behaviors, like smoking, and a checklist of screenings, shots, and preventative services for the year. They will also check for any cognitive impairment. Your primary care physician may even provide advance care planning.

How Much Do These Visits Cost?

In terms of costs, both of these types of visits are covered entirely by Medicare insurance, as long as your health care provider accepts assignment. You might be charged some or all of the costs of any additional tests or services your care provider suggests that aren’t covered under preventative care during the visit. The Part B deductible applies to “extra” tests and services, and you may be billed coinsurance for them. You should also specify with your doctor that you’re scheduling an annual wellness visit and not an annual physical, which you may have to pay for.

Wellness visits are underutilized by eligible citizens, despite the good they can do. If you’re within your first 12 months of your Part B enrollment, speak to your doctor about setting up your Welcome visit. If you’ve been enrolled for longer, set up an Annual Wellness visit for your yearly health care consultation.

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