What Isn’t Covered in Medicare’s Annual Wellness Visit

If you’re new to Medicare, you might be a little confused about what is covered by Medicare and what isn’t. But it’s very important to understand your coverage, because assuming a visit or treatment is covered when it isn’t could mean receiving a surprisingly large bill in the mail. For example, as a Medicare beneficiary, you can see your doctor every year for an annual wellness visit, but some things are not covered during this visit. Find out what isn’t covered so you can avoid an unexpected bill. 

What Can You Expect at an Annual Wellness Visit?

If you’ve had Medicare Part B for longer than 12 months, you can get an annual wellness visit.  This wellness visit isn’t a physical exam; it’s meant to help you create or update a personalized health plan for preventing disease and disability, based on your current health and risk factors. 

During your annual wellness visit, your doctor will ask you to fill out a questionnaire called a “Health Risk Assessment,” so they can develop a more personalized prevention plan for you. They will also:medical record

  • Review your medical and family history.
  • Review your current providers and prescriptions.
  • Check your height, weight, blood pressure, and other routine measurements.
  • Offer personalized health advice.
  • Provide a list of risk factors and treatment options for you.
  • Create a screening schedule (like a checklist) for appropriate preventive services, and give you details about coverage for screenings, shots, and other preventive services.
  • Provide advance care planning

Your doctor will discuss your health and any changes in your household, and work together to create a personal health plan for the year ahead. 

What Is Not Covered?

  • Sick visits– If your time with your doctor involves a discussion of an illness or symptoms, and your doctor recommends care or a treatment plan, you will be charged a copay and/or have to meet your deductible.
  • Chronic illnesses– Your visit will not cover any discussion, treatment, or prescription of medications for chronic illnesses or conditions, such as high blood pressure, high cholesterol, or diabetes. If it does, you will be charged a copay and/or a deductible.

Extra Coverage

gold piggy bank
If you want to save more money, then consider looking into a Medicare Supplement Plan, which can save you thousands each year.

So, while your Medicare annual wellness visit is an excellent tool for keeping you healthy, there are important things that it doesn’t cover. Not only that, but in general, Medicare Part B will only cover the cost of any services or treatments you receive at 80%, leaving you to pay the other 20% out-of-pocket. This can get quite expensive, especially if you are living on a fixed income, as many Medicare beneficiaries are. Fortunately, though, you can save money on all your medical expenses and get extra coverage by purchasing a Medicare Supplement Plan. 

There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans for you in minutes at no cost to you. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.

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 *