Most adults with access to healthcare are familiar with the yearly physical: the annual appointment where your doctor reviews your medical and family history and performs physical exams — taking your measurements, checking your reflexes, collecting samples for testing — to assess your body’s health. However, when you enroll in Medicare, you are entitled to annual wellness visits (AWVs), a covered benefit that can supplement your yearly physical.
Medicare annual wellness visits were introduced in 2011 to encourage more people to seek out preventive services. Preventive services are important for everyone, but older adults, especially, can use these services to improve their quality of life. Older adults are at a greater risk for heart disease, memory and cognitive issues, and loss of mobility, making the need for preventive care in AWVs especially important. Here’s what you need to know about annual wellness visits.
What is Medicare’s annual wellness visit?
The Medicare annual wellness visit is a yearly check-in with your doctor to assess your physical, mental, emotional, and social health and make a wellness plan for the future. The annual wellness visit begins after your first 12 months on Part B. Before that, you’re allowed one “Welcome to Medicare” visit, an initial preventive visit to assess your overall health and offer a plan of preventive services you need.
A Medicare annual wellness visit includes a health risk assessment questionnaire, in which you self-report questions about your overall health, your feelings about finance, work, and relationships, your exercise habits, and more. Your doctor may also:
- Review your medical and family history
- Record current medications and prescriptions
- Check your cognitive wellness
- Screen for depression
- Measure and document your height, weight, and blood pressure
- Give health advice
These questions give your healthcare providers insight into your health, which allows them to create a personalized wellness plan for fighting disease and preventing disability where possible.
What’s the difference between Medicare annual wellness visit and a physical?
Both a yearly physical exam and a Medicare wellness exam are important to maintaining your health, but there are key differences to note between the two.
First, the Medicare annual wellness visit is a review-based assessment of your overall health, while the physical involves examining your physical health. For example, a physical includes testing your reflexes, examining parts of your body to feel for growths or abnormalities, and listening to your heartbeat and breathing, which the AWV does not.
Please note that this is not an exhaustive list. Your doctor might include different assessments based on age, gender, and current health.
Additionally, whereas the yearly physical focuses on your physical health, the Medicare annual wellness visit focuses on your overall health, including your mental health, emotional well-being, and quality of life. Though the AWV doesn’t include a physical exam, it does help your doctor create a wellness plan that allows you to get care that is personalized to your needs — including screenings and preventive services.
Tips for avoiding extra out-of-pocket costs during Medicare’s annual wellness visit
Avoid extra costs by staying within the service allowances of the annual wellness visit benefit. Medicare covers both your “Welcome to Medicare” visit and your annual wellness visit, but not annual physicals. If you continue to receive yearly physicals, you will have to pay out of pocket.
Also, the Part B deductible doesn’t apply to annual wellness visits. If you receive treatment for a health issue during your visit, you may have to pay coinsurance and the Part B deductible. For example, if your doctor performs a physical exam, runs tests, or provides any additional services during your annual wellness visit, you may be responsible for the full cost.
When scheduling your Medicare annual wellness visit, be sure to explicitly state that as the reason for your visit. This way, you can avoid your appointment being scheduled as a regular service visit, which will likely incur unexpected costs.
How annual wellness visits impact your overall health
Annual wellness visits help doctors understand contributing risk factors rather than just physical symptoms. For instance, your doctor can screen for signs of loneliness — which impacts one in three adults aged 50-80 and increases the risk of high blood pressure, heart disease, and depression — assess your risk level, and create a plan that caters specifically to your long-term health.
While the annual wellness visit isn’t mandatory, it’s a helpful preventive benefit that can help you plan for and receive holistic care. You may no longer receive routine physical exams, but the AWV equips your doctor with a comprehensive view of your health so you can access the exact tests, treatments, and medications you need to preserve your health in your golden years.
