Updated February 2023
Annual Wellness Visits are a benefit available to all Medicare patients and you will pay nothing for the visit, only for any follow up tests or medical services your doctor thinks are necessary. The main goal of an Annual Wellness Visit is to dedicate time with your provider to discuss your overall health status, look for signs that may point to a hidden health condition, and create or update your healthcare plan for the year.
Annual Wellness Visits are not the same as Annual Physicals. An annual physical is a more extensive exam that usually includes services such as vital checks, a lung exam, head/neck exam, abdominal exam, neurological exam and reflexes. Medicare does not pay for this type of exam.
Why is Getting an Annual Wellness Visit Important?
An Annual Wellness Visit gives you and your primary care provider the opportunity to:
- Understand your current health status
- Identify and review potential health risks early, when they are easier and less costly to treat
- Take appropriate actions, such as scheduling future appointments or services, to improve your health outcomes
- Form a relationship that benefits you both
Types of Annual Wellness Visits and What to Expect from Each
Your Annual Wellness Visit will be one of three types of visits listed below, depending on how long you have had Medicare coverage.
1. Welcome to Medicare Preventive Visit
If you have had Medicare for 12 months or less, your first Annual Wellness Visit will look like this:
- A review of your medical and social history such as family history, diet, current medications, history of drug/alcohol use, and physical activities
- A review of risk factors of depression
- A review of your level of safety
- A physical exam including height, weight, body mass index, blood pressure, visual acuity screen, and any other exams necessary based on your health history
- An opportunity to discuss your care preferences should you be unable to communicate them, if it’s something you would like to talk about
- Access to educational resources and counseling if needed
- An opportunity to get referrals for preventive services if needed
- A written plan of next steps regarding your healthcare
2. Annual Wellness Visit
If you have had Medicare coverage for more than 12 months and you have not received an Initial Preventative Physical exam or an Annual Wellness Visit in the past 11 months, your Annual Wellness Visit will look like this:
- A Health Risk Assessment including a self-assessment of your health, possible risk factors to your health, information on where you are living, and your daily activities
- A review of your medical history including family history, current medications, risk of depression, and level of safety
- A physical examination including height, weight, body mass index, blood pressure, and any other routine measurements that are necessary based on your medical history
- Establish a prevention plan with your doctor including a list of all your current healthcare providers, a plan for preventive services to maintain or improve your long-term health, and a list of your risk factors with treatment options
- Get personalized health advice, educational/counseling resources, and referrals to any specialists you may need
3. Subsequent Annual Wellness Visits
If you had an Annual Wellness Visit in the past 11 months, your next Annual Wellness Visit will look like this:
- An updated Health Risk Assessment including an update of your medical and family history and your list of healthcare providers
- An updated physical examination including your blood pressure, height, weight, and other routine measurements as necessary
- Update your plan for preventive services to maintain or improve your long-term health
- Update your list of risk factors and assess if you need care for any of these risks
- Update your medical and surgical history
- Get personalized health advice and referrals
Preventive Services Your Doctor May Recommend
Your doctor will be able to answer any questions you may have on why he or she recommends certain services and whether Medicare will pay for them. Recommended services may include:
- Influenza vaccination (flu shot)
- Pneumonia vaccination – recommended annually for those age 65 or older
- Colorectal cancer screening – to help physicians find growths in your colon and rectum before they become cancerous or find cancer at an early stage.
- Breast cancer screening for women, including mammogram
- Cardiovascular screening – blood cholesterol and fat tests to check your heart health
- Statin therapy for patients with cardiovascular disease
- Diabetes screening – a blood test that can detect if your blood has too much sugar
- Diabetic eye exam for patients with diabetes
The Difference Between an Annual Wellness Visit and a Physical Exam
An Annual Physical is a more extensive exam. While the services listed above will occur during your Annual Wellness Visit, an Annual Physical will look more like this:
- Measure your height, weight, blood pressure and body mass index
- Review your medical and family history
- Assess your risk factors for preventable diseases
- Check vitals
- Head, neck, lung, abdominal and neurological examination
- Test reflexes
- Gather urine and blood samples for lab testing if necessary
How to Schedule Your Annual Wellness Visit
If your primary care provider is part of Arizona Care Network, we can help you schedule your Annual Wellness Visit. Contact ACN’s concierge line at 602.406.7226 or email members@azcarenetwork.org.
ACN’s Care Coordination team can help you coordinate care for any healthcare needs your primary care provider recommends after your visit. Our team of healthcare insiders work with your doctor to give you the extra support you need to get healthier and stay healthier. There is no charge to eligible patients for care coordination services.
