Once a year, Medicare will provide seniors with the benefit of a free annual wellness visit. This exam is aсtually just an in-person meeting with your health care team aimed to discuss and evaluate your current health condition and steer your focus towards health maintenance and disease prevention. You become qualified for the Annual Wellness Visits after you’ve had Medicare Part B for 12 months.

The primary purpose of a Medicare wellness visit is for a professional healthcare team to review your overall health, and upon reviewing it, create a prevention health plan that is tailored to your specific condition. These exams are also believed to reduce the number of trips to the doctor’s office. 

A Medicare wellness exam should not be confused with an Initial Preventive Physical Examination (IPPE), which is only available during the first 12 months of enrollment in Medicare Part B.

Medicare wellness exam is aсtually just an in-person meeting with your health care team aimed to discuss your current health condition.

What to expect in an annual wellness visit by Medicare? 

Medicare invests in these visits to keep its beneficiaries healthy. It can set you up on a new and improved preventive health plan that is personalized and considers your medical history as well as current medical conditions. It also discusses issues related to your referrals and private practitioners, trying to provide you with the best solutions available. 

Here’s what you can expect in an annual wellness exam.

A discussion with the provider about your health

During the wellness visit, you will be asked to fill in a Health Risk Assessment Questionary. Apart from that, the provider may take a look at your current prescription drugs, review your family history, discuss your daily activities, habits, and lifestyle in general. This will help the doctor better understand your current health needs and create a prevention plan to eliminate health risks for you.

Taking measurements of the patients, including: 

  • Height;
  • Blood Pressure;
  • Body Mass Index 

Other tests:

  • Risk factors for depression
  • Cognitive function assessment 
  • Functional ability and safety

How to make your annual wellness exam easy?

To make your annual wellness exam quick and easy, make sure that you have the following information handy on the day of your visit. First, info about vaccinations that you received, along with prior surgery and treatment dates. If you receive the flu vaccine at a practice other than your doctor’s office, then it is important to include your vaccine dates. 

Along with the vaccine dates, you should also include the information about all medical specialists that you have been seeing. This list can include a cardiologist, an OB/GYN, or a urologist. Apart from that, make sure that you have your prescription supplements and any other over-the-counter medications with you, and that they are in their original containers. 

Is Medicare wellness exam a waste of time? 

Considering the number of benefits that you can get from these visits, it is safe to say that they are not a waste of time. They are an opportunity for patients to sit with their physicians once a year and review their medical history and preventative care strategies. All of this comes at no cost to you, and this is a benefit that should not be underestimated. 

However, even though the visits are very beneficial, some people are indeed unhappy about their wellness visit, mostly because they expected this visit to be something it is not. A wellness visit is not a physical or a sick visit. You won’t get a detailed medical examination and you won’t be put on any treatment plans. Many are disappointed to learn that the wellness visit is just a conversation about your overall health, lifestyle, and family history. In many cases during a wellness visit when specific health issues are raised, patients are either told to schedule a separate appointment with their doctor or are charged a copay/deductible for what they thought was a free service.

Naturally, many feel frustrated in this case and find the visits useless. This is because the nature of the annual wellness visit is different from a physical or a sick visit.

Physical exam vs wellness exam

Unlike a wellness visit, Medicare does not cover an annual physical exam. Medicare’s annual wellness visits are yearly checkups for preventative purposes. Usually, during this visit, the patient will fill out a health risk assessment form, and the doctor will then use this questionnaire to assess any risk factors and schedule any additional tests or preventative measures that they feel are necessary. 

On the other hand, a routine physical offers a more thorough check of the current health condition. In it, the doctor will touch, look, and feel the parts of the patient’s body to determine whether any additional examinations are needed. In short, a Medicare wellness visit is a conversation, whereas in a routine physical exam the physician is more hands-on. 

What a Medicare wellness visit is not

Wellness visits are not designed to:

  • Diagnose and treat any specific conditions (new or chronic). If you need medical help with a specific problem (e.g. you caught a cold and are not feeling well or you’ve been getting some severe headaches recently), you need to schedule a separate appointment with your doctor.
  • Perform any medical tests (lab tests or X-ray);
  • Prescribe new prescription drugs;
  • Make any changes to your current treatment plan;

Can you refuse a Medicare wellness visit? 

Yes, you can refuse a Medicare Annual Wellness Visit. It is not mandatory for patients and cardholders to participate in this visit even though most will usually benefit from it (especially given that it is free of charge). 

Since Medicare Wellness Visits are voluntary visits you are entitled to on a yearly basis, they do not have any impact on your Medicare coverage so there’s no penalty if you choose not to go. 

Final thoughts 

Medicare wellness exams can be some of the most insightful, revealing, and even life-saving visits to the doctor’s office. Most of the time people delay their health checkups until their condition gets extremely bad. 

For this reason, it is important to take precautions and talk about your health with a specialist even if you feel like you do not need to. Using this free-of-cost opportunity provided by Medicare can be the best thing you do for prevention. 

Article updated on January 23, 2024

•January 23, 2024