Don’t Forget Your Annual Wellness Visit

Medicare covers a number of preventive care services free of charge to Medicare beneficiaries. These preventive services are an important part of reducing overall costs by preventing more expensive hospitalizations and medical treatments later on.

One of the most important free preventive care services are your initial “Welcome to Medicare” visit that you are entitled to when you first sign up for Medicare, and your subsequent annual wellness visits that you receive after that.

If you’ve been enrolled in Medicare Part B for at least twelve months, you are entitled to a free wellness visit every year with your primary care doctor.

Why It’s Important

Take advantage of your annual wellness visit. It’s important. Your wellness visit helps ensure you’re on track with your overall preventative medicine and health planning.

 In fact, your annual wellness visit is so important that Medicare makes it absolutely free. If your doctor accepts assignment, you normally pay nothing out-of-pocket for your visit. The usual Part B deductible doesn’t apply. And there’s no copay or coinsurance.

Note: Your annual wellness visit is not the same thing as an annual check-up. Your wellness visit doesn’t include a detailed physical examination, imagery, mammograms, or lab work.

 You should absolutely consider getting an annual checkup every year as well as your wellness visit. But they are different things, and it’s important to understand the distinction.

Your wellness visit is free. But the annual checkup and other services not included in the wellness visit will be subject to deductibles and copays, like other services under Medicare Part B.

What You Can Expect At Your Annual Wellness Visit

At your  first annual wellness visit or “welcome to Medicare” visit,, your doctor will have you complete a form called  a Health Risk Assessment. This is just a general form asking for basic information about your medical history and risk factors. So your doctor knows what medical issues to focus on.

Your accurate answers on your Health Risk Assessment will help your doctor work with you to create a personalized preventive care plan. So you can stay healthy and out of the hospital.

Your wellness visit may include: 

• a height and weight check
• blood pressure check
• a review of your family medical history as well as your own
• an update of your current providers and prescriptions
• counseling on your major risk factors
• referrals to educational and preventive resources
• a conversation about your advance care planning and living will documents. 
• recommendations for immunizations

Your doctor will also screen for signs of Alzheimer’s disease and other forms of dementia. If he or she believes you may be developing signs of a cognitive disorder like Alzheimer’s, Medicare will also provide an additional free visit for a more thorough assessment, and to design a care plan. 

Immunizations

You may also receive recommended immunizations at your wellness visit. These aren’t typically included as part of your free annual wellness visit. But many immunizations are also provided free of charge under Medicare. So they won’t affect your billing.

“Check-up” Services In Addition to Wellness Visit Services May Be Billed.

If you have other services done while you’re at your free annual wellness visit that aren’t typically considered a wellness visit service, you may have to pay deductibles, copays, and/or co-insurance.

This is a frequent source of confusion for Medicare beneficiaries. Sometimes, patients get surprised by doctors’ bills for additional services they received during their wellness visit that aren’t included under the wellness visit heading.

For example, if you come to your free wellness visit, complain about chest pain and shortness of breath, problems your doctor may have an electrocardiogram (ECG) done right there in her office.

In that event, you won’t be charged for the wellness visit. But you would potentially get charged for the ECG,, up to your Plan B deductible ($226 as of 2023), a small copay and your 80% co-insurance under Part B, unless your Medigap or Medicare Advantage plan picks it up. 

Not Mandatory, But a Great Idea.

Your annual wellness visit is optional. 

But studies show that patients who attend their free annual wellness visits are more likely to receive additional preventative medical services, such as prostate and breast examinations, high blood pressure screenings, blood sugar/diabetes screenings, vaccinations, mental health consultations, and other critically important services.

These early detection and prevention screenings can literally save your life.

Thanks again, and from all of us at MediGap Advisors, have a blessed holiday season.

To your health and wealth,

Wiley P. Long, III
President – MediGap Advisors