What it is
You can get an annual wellness visit as often as every 12 months. During this exam, your doctor will review your current health and medical needs, and with your help, create a prevention plan just for you.
At the first visit, your doctor will create a plan and schedule to help you stay well, including certain screenings and shots you should get over the next 5 or 10 years. The plan will include making a list of your current doctors and medications. Your doctor will record your medical history and check your blood pressure, weight, height and body-mass index. Your doctor will screen you for dementia, or memory loss, as well as depression and other mental health conditions.
Your doctor may refer you to other professionals for other health care. Your doctor may give you a vision test and an Electrocardiogram (EKG), plus any other tests that may help you stay well.
The later exams will build upon the prevention plan created in the first visit. Your doctor will take routine measurements, including weight, height, and blood pressure. Your doctor may order further tests or make new referrals if you need them. Your doctor will also update your screening schedule and again review your health and mental status based on your current health needs.
Why it is important
This exam is a great way to stay ahead of your health. You can meet with your doctor every 12 months and get the important screenings, shots, and referrals you need to help you stay healthy.
Who is covered
Anyone who has Medicare Part B for more than 12 months can get the annual wellness visit.
Important: You do not need to get the “Welcome to Medicare” exam before you get the annual wellness visit. But if you do get the “Welcome to Medicare” exam when you enroll in Medicare Part B, you will have to wait 12 months to get your first wellness exam. In other words, you cannot get the “Welcome to Medicare” exam and your first wellness exam during the same 12 month period.
How often it is covered
The wellness exam is covered once every 12 months.
What you pay
You pay nothing for the cost of the exam if you have Original Medicare and you see a doctor who “accepts assignment.” Doctors who accept assignment agree to accept the amount that Medicare will pay for a visit or service (called the Medicare-approved amount) as payment in full.
If you are in a Medicare Advantage plan, the plan cannot charge you for this service as long as you see an “in-network” provider, meaning a doctor who has an agreement to treat people who belong to the plan. If you use a provider outside your plan's network, it may cost you money.
Note: You may have to pay for some costs in either Original Medicare or in a Medicare Advantage plan if your doctor does other tests or procedures during this visit that are not included as part of the wellness exam. Talk with your doctor.
Learn more about the Annual Wellness Visit on Medicare.gov.