Medicare Wellness Visits

Your Medicare preventive visit and yearly wellness exams are your annual chance to discuss your plan of preventive care with your provider.

“Welcome to Medicare” Preventive Visit

This visit is available within the first 12 months of enrolling in Medicare Part B. It includes a review of your medical and social history related to your health and education/counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed. Your provider will ask you to fill out a Health Risk Assessment. Answering these questions can help you and your provider develop a plan to stay healthy and get the most out of your visit.

During your visit, a nurse or provider will:

  • Record your medical and social history (alcohol or tobacco use, your diet and activity level)
  • Check your height, weight, and blood pressure.
  • Calculate your body mass index (BMI).
  • Give you a simple vision test
  • Review your potential risk for depression and your level of safety.
  • Offer to talk with you about creating advance directives, which are legal documents that allow you to put in writing what kind of healthcare you would want if you were too ill to speak for yourself.

When you come for your Welcome to Medicare Preventive Visit, plan to bring the following items:

  • Any forms you were asked to complete prior to your visit
  • All of your medication containers (including prescription and over-the-counter medications in their original container)
  • Driver’s license
  • Insurance card
  • Advance Directives, if you already have one

Annual Wellness Visit

If you’ve had Medicare Part B for more than 12 months, you can schedule your Annual Wellness Visit to create or update a personalized prevention help plan. This plan is based on your current health and risk factors to prevent disease and disability. Your provider will ask you to fill out a Health Risk Assessment. Answering these questions can help you and your provider develop a plan to stay healthy and get the most out of your visit.

This visit includes:

  • Health risk assessment
  • Review of medical and family history
  • Develop or update a list of current medical providers and prescriptions
  • Height, weight, blood pressure, and other routine measurements
  • Detection of any cognitive impairment
  • Personalized health advice
  • A list of risk factors and treatment options for you
  • A screening schedule (like a checklist) for appropriate preventive services

Frequently Asked Questions (FAQs)

What preventive medical visits does Medicare cover?
Medicare pays for two wellness visits: a one-time Welcome to Medicare Visit and an Annual Wellness Visit.

Within the first 12 months you have Medicare Part B, Medicare covers the one-time Welcome to Medicare Visit.

You are eligible for your first Annual Wellness Visit if you have been enrolled in Medicare for more than 12 months and have not had a Welcome to Medicare Visit in the last 12 months.

What is the difference between the Welcome to Medicare Visit and the Annual Wellness Visit?
Your first Annual Wellness Visit has a lot in common with the Welcome to Medicare Visit. The main difference is the timing. If you are newly enrolled in Medicare, you are eligible for the one-time Welcome to Medicare Visit only within the first year. The Annual Wellness Visit can take place every 12 months and the first visit can be scheduled either 12 months after the Welcome to Medicare Visit or after more than 12 months of your enrollment in Medicare.

How are the Welcome to Medicare Visit and the Annual Wellness Visit different from a yearly physical?
An annual physical is a much more extensive examination than the Welcome to Medicare Visit or Annual Wellness Visit. In addition to collecting a medial history, it may also include a vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, dermatological exam, and extremities exam.

Clinical laboratory tests are not include in either the Welcome to Medicare Visit or Annual Wellness Visit. If your provider needs to evaluate and treat a medical problem during one of these wellness visits, he or she would need to charge for this separately, and the cost of the tests would be applied to your deductible or copay.

Is there a deductible or copay for the Welcome to Medicare Visit or the Annual Wellness Visit?
No, there is no deductible or copay for either one.

But keep in mind that either of these visits could cost you some money out of pocket. For example, you may need to have a medical condition evaluated or treated in a way that goes beyond the purpose of a wellness visit. Under Medicare rules, the additional time or treatment would be billed as an office visit, with Medicare paying 80% of the allowed charges and the rest being applied to your deductible or copay.

I'm new to Medicare and normally receive a full physical exam from my provider every year. I'm due for my next physical, and since I'm eligible for a Welcome to Medicare Visit, how should I schedule my appointment?
When you call your provider’s office, explain that you want the Welcome to Medicare Visit, which Medicare will cover, in addition to your annual physical. The amount applied to your deductible or copay will be the difference between what Medicare pays for the Welcome to Medicare Visit and the full preventive examination fee that your doctor charges for the rest of the physical.

Also you should be aware that scheduling this appointment with your provider’s office entirely as an annual physical exam will mean that the visit will not be covered by Medicare and will be applied directly to your deductible or copay.