Medicare Annual Wellness Visit

The annual wellness visit is a Medicare benefit that is provided free of charge for patients who have had Part B coverage for one year or more. It is designed to promote healthy habits among Medicare enrollees and help detect any potential health issues early on. In addition to a review of the patient’s risk factors and family health history, physicians will also be able to update their preventive care plan and screening schedule and provide education and counseling regarding any identified issues. This is a great opportunity for patients and doctors to ensure they are on the same page regarding future health.

Unlike a physical, an annual wellness visit does not include blood tests or listening to your lungs. However, preparing for your AWV is still important. Your doctor may send you some questionnaires to complete before your appointment; having these available is best.

Difference Between Preventive and Annual Wellness

The “Welcome to Medicare” preventive visit and the yearly wellness exam are two different visits. You must wait 12 months after your first visit to qualify for a yearly wellness exam, and you can’t have this type of visit within the same year as your initial preventive exam or the AWV.

Annual wellness exams focus on a patient’s health risk assessment and include assessments that don’t require physical contact with the doctor, such as blood pressure and heart rate. During this visit, doctors also review the patient’s medical, family, and social history.

On the other hand, annual physicals cover a head-to-toe exam and typically involve a full body examination. The difference between these types of appointments can cause confusion and create billing pitfalls for providers. To avoid any confusion, it is important for providers to clearly define the purpose of a visit before scheduling an appointment. This will help ensure the correct coding and billing is used for the service provided.

How Do I Prepare for an Annual Wellness Visit?

The yearly wellness visit allows patients and physicians to create or update a personalized prevention plan to prevent illness and disease. It can include family health history, screenings for cancer and other conditions, education on health behaviors, referrals to community resources, and voluntary advance care planning. Medicare covers annual wellness visits at no cost if you’ve been enrolled in Part B for over 12 months. If you receive additional tests or services during your AWV, these may be billed to your insurance.

Patients must prepare for their AWV to ensure the visit meets their expectations and feels productive. For clinicians, it’s essential to understand the difference between a yearly wellness visit and an annual physical. Together, these efforts can help improve patient outcomes and reduce administrative burdens. Learn more at the Medicare Learning Network.