Is The Medicare Annual Wellness Visit Mandatory?

When you sign up for Medicare, you will receive several preventive care services at no cost to you. The exams and screenings offered to you are meant to assess your overall health and your risk for developing certain illnesses. One of these free preventive care services is the Medicare Annual Wellness visit. Many wonder if this visit is a mandatory part of maintaining Medicare Part B coverage. While it is not mandatory, it is beneficial.

What’s Included In the Medicare Annual Wellness Visit

older caucasian man with a nurse
Your doctor will check your family history, check your weight, blood pressure and more, while offering personalized heal advice/plan. 

The purpose of a Medicare Annual Wellness Visit is to check your overall health, assess your risk factors, and create a wellness plan to help prevent any illnesses you may be at risk for. Your doctor will briefly examine you, but this visit is not to be confused with a physical. A physical is a more comprehensive visit, at which your doctor checks you from head to toe and asks for lab work to be completed. Medicare does not cover physicals, but a Medicare Annual Wellness Visit is the next best thing.

At these visits your doctor will:

  • Review your medical and family history.
  • Check your height, weight, blood pressure, and other routine measurements.
  • Develop or update a list of providers and prescriptions.
  • Offer personalized health advice.
  • Create a list of risk factors and treatment options for you.
  • Discuss a plan for care in the event that you are unable to take care of yourself.
  • Screen you for conditions such as dementia and depression.

Eligibility For the Medicare Annual Wellness Visit

In order to be eligible for a Medicare Annual Wellness Visit, you need to have been enrolled in Medicare Part B for at least 12 months. When you first sign up for Part B, you will have an initial Welcome to Medicare Exam within the first 12 months of your enrollment. Once you have had this exam, then you are eligible to begin having an Annual Wellness Visit every year. 

Medicare will cover your Annual Wellness Visits 100% as long as you see a participating Medicare provider. However, if your doctor prescribes any additional treatments or lab work in the course of this visit, then Medicare will cover 80% of the costs of these extras. 

illustration of pill bottle with 2 bills beside it
When going to your doctor, bring your medication with you.

What To Bring To The Visit

Before you go to your first Medicare Annual Wellness Visit, you will need to fill out a long health risk assessment questionnaire. To avoid sitting at the doctor’s office filling out this form, you can request that it be mailed to you. That way, you can fill it out at home and have it ready when you go to your appointment. In addition to this form, bring any medications you are taking and a list of questions/concerns you may have.

When scheduling your appointment,  make sure you let your doctor’s office know that you are scheduling an Annual Wellness Visit and not a regular checkup or wellness visit. If you are not clear about this, you could be charged for a regular wellness visit. 

Medicare offers you free preventive care visits so that you can stay on top of your health. So while it is not mandatory to go to these appointments, it is definitely a good idea – you’ll be able to assess your risks and come up with a proactive plan to stay healthy. Your doctor will go over all of your  medications, address any concerns, and come up with a new health plan and treatments for you to follow. These visits will keep you feeling your best; they could even end up saving your life.

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

Leave a Reply

Your email address will not be published. Required fields are marked *