Understanding Your Medicare Annual Wellness Visit

Each year, individuals enrolled in Medicare Part B can take advantage of an Annual Wellness Visit (AWV). This type of visit isn’t a physical exam, but a chance for participants and their healthcare providers to develop a personalized prevention strategy. While tests can seem daunting, they can also spark questions and anxieties—like any doctor visit. To clarify what to expect, we spoke with some leading Medicare experts about preparing for this exam and maximizing your experience.

What to Anticipate During Your Medicare Annual Wellness Visit

The Medicare Annual Health Exam differs from a typical annual exam. Whitney Stidham, vice president of consumer empowerment at eHealth, points out that “this visit is not about testing for preventive care; rather, it centers on reviewing a patient’s personal and family medical history alongside current medications.”

She adds, “Your physician may plan future preventive tests and give tailored medical advice. There might also be cognitive screenings to detect signs of issues such as early-stage dementia or Alzheimer’s disease.”

To qualify for this appointment, patients must be enrolled in Medicare Part B for a minimum of 12 months. If that’s the case for you, Stidham recommends reaching out to your primary care doctor to set up a visit.

“An annual physical is among the most valuable benefits most insurance health plans, including Medicare, provide,” she notes. But interestingly, a recent survey found that about 20% of Americans do not usually have annual checkups. Additionally, a similar percentage is unaware that most insurance plans cover the cost of an annual checkup with in-network providers, at no extra charge.

Cost of a Medicare Annual Wellness Visit

If your doctor accepts Medicare, your annual checkup shouldn’t result in any charges, according to Stidham.

However, she notes that some patients may face out-of-pocket expenses for additional diagnoses or services outside the wellness visit scope. It’s advisable for Medicare beneficiaries to ask their doctors about any potential costs during their appointments.

Preparing for Your Medicare Annual Wellness Visit

Stidham suggests bringing a list of all current medications and dosages to streamline your appointment. “Make sure to provide your doctor with a clear account of your personal and family medical history as well as your medication use. If it’s helpful, jotting down notes can aid in communication,” she advises.

While some individuals may feel the urge to prepare for a cognitive assessment, Stidham reassures, “There’s no need to study beforehand. Typically, the doctor will ask straightforward questions and run a basic memory check. You might be asked to draw a clock set to a specific time or recall certain words after a brief interval.”

Key Preventive Screenings for Medicare Patients Following a Physical Exam

Post-annual checkup, it’s crucial to focus on various preventive tests, according to Stidham.

“You should prioritize screenings for blood pressure, cholesterol, and diabetes, especially for those with a high body mass index (BMI). Adults aged 55 to 80 who are heavy smokers should consider lung cancer screening,” she advises. Additionally, women are encouraged to undergo mammograms every one to two years starting at age 40, as well as cervical cancer screenings until age 65. Colorectal cancer screenings are recommended for those aged 50 to 75, while prostate screenings are suggested for men.