Your Medicare Annual Wellness Visit: A Simple Guide

This guide explains your Medicare Annual Wellness Visit. It covers what the visit is, what it costs, what to bring, and what to expect.

What Is a Medicare Annual Wellness Visit?

Your Medicare Annual Wellness Visit is about staying healthy, not just treating illness when it happens.

At this visit, your provider will:

• Get to know your health goals
• Build a health plan made just for you
• Look for early warning signs of health risks

This visit is covered by Medicare Part B. It is designed to help you stay on top of your health and catch problems early, before they become serious.

Types of Medicare Annual Wellness Visits

There are three types of visits. Which one applies to you depends on how long you have had Medicare.

1. Initial Preventive Physical Exam (IPPE)

This is a one-time visit for people who are new to Medicare. You can get this visit within your first 12 months of having Medicare.

• This visit includes an EKG test.
• The EKG test cost will count toward your copay or deductible.

2. Initial Annual Wellness Visit

If you did not get your IPPE during your first 12 months on Medicare, this visit becomes your first Wellness Visit instead.

• There is no copay.
• There is no coinsurance.
• There is no deductible.

3. Subsequent Annual Wellness Visits

After your first Wellness Visit, you can get this visit once every year.

• Medicare covers this visit fully. There is no copay, coinsurance, or deductible for the visit itself.
• However, if your provider orders a diagnostic test or service during the visit, that test or service will count toward your copay or deductible.

Crafting Your Personalized Health Plan

Your provider and care team will work with you to build a health plan made for your needs. This plan may include:

• Your health goals. What matters most to you.
• Fall prevention. Steps to help you stay safe and avoid falls.
• Bladder health. Support for any bladder-related concerns.
• Recommended vaccinations. Shots that can help protect your health.
• Preventive screenings. Tests that can catch problems early.

This list is not the only thing your plan may cover. Your provider will tailor it to you.

What If I Have Additional Concerns?

Sometimes you may have a new symptom or an ongoing health problem you want to talk about. The good news is your provider can often handle this during the same visit.

Please note:

• If you bring up a new concern, your provider will need to do a separate medical evaluation.
• This separate evaluation will come with an additional charge. This could be a copay, coinsurance, or deductible amount.

You always have a choice. You can either:

• Address your additional concern during your Wellness Visit, or
• Schedule a separate appointment on a different day or time.

Neither choice is wrong. Pick whichever works best for you.

What to Bring to Your Annual Wellness Visit

To make the most of your visit, please bring these three things with you:

1. A list of all your doctors and caregivers. Include everyone who helps with your care.
2. A complete list of your current medications. Be sure to include vitamins and supplements too.
3. Information about any recent ER visits or hospital stays. This helps your provider understand your recent health history.

Bringing this information helps your provider give you the best possible care.

Have Questions?

For any additional questions about your Medicare Annual Wellness Visit, please speak to our front desk staff. We are happy to help.

Frequently Asked Questions About Medicare Annual Wellness Visits