What to Expect from Your Medicare Annual Wellness Visit

As you get older, it’s important to take control of your health through routine and preventative care. One way to do this is through a Medicare Annual Wellness Visit (AWV). This is free to all individuals on Medicare, with or without an advantage care plan or ‘supplement.’ Some seniors get confused about how it differs from a physical and what’s covered. We’ll try to clear this up in this brief post.

It’s not so bad!

If you or a loved one are on Medicare, you may be wondering what to expect from your Medicare Annual Wellness Visit. Check out this short video from Embrace the Journey for a fun and positive look at the Medicare Annual Wellness Visit, what you’ll be answering on the health screening forms, and what to expect through your appointment.

What is the Medicare Annual Wellness Visit?

The Annual Wellness Visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan.

The Annual Wellness Visit is a preventive service that helps identify risk factors for Medicare patients to assess aspects of your self-reported health status, family history and medical history. It begins with questions from a health risk assessment (HRA), which you can complete on your own prior to the visit.  

It collects a host of demographic information, questions about your ability to move around independently, participate in daily activities, your use of medications, your general mood, sleep habits, lifestyle, and more. Your doctor will go over these and make a care plan for anything concerning.

This comprehensive review will identify any risks factors that may impact your physical or mental health, so they can be addressed before it becomes too late. Most visits also include cognitive health screening.

Who is eligible for an Annual Wellness Visit?

Eligible beneficiaries are individuals who have not received either an initial preventive physical examination or annual wellness visit in the past 12 months.

An initial AWV is available to the beneficiary during the second year of eligibility for Medicare and can be done yearly thereafter.

Bear in mind that if you’re new to Medicare, your first visit may be longer and more comprehensive, and even go by another name, such as the ‘Welcome to Medicare’ preventive visit.

What you can expect from your Annual Wellness Visit

Here’s what you can expect from your Annual Wellness Visit and why it’s an important part of staying healthy as you age.

During your Annual Wellness Visit your doctor will check in with you about your overall health and any changes or concerns you may have. They’ll also perform some basic screenings and assessments, like checking your blood pressure and weight, and update your immunizations if needed.

Your primary care provider will then review your medical record and exam with you to determine the risk for common preventable health problems, such as heart disease, cancer or type 2 diabetes. Based on this information they create a personalized prevention plan that includes screenings needed to avoid these risks!

During your Medicare Annual Wellness Visit, your provider will:

• Collect your health history, including surgeries, hospital stays, allergies, treatments, and medications
• Measure your height, weight, body-mass index, and blood pressure
• Review your health risk assessment, which is self-reported information from you and includes demographic information, and questions about your frailty and physical functioning
• Assess your behavioral risks, such as tobacco use, physical activity, nutrition and oral health, alcohol consumption, sexual health, motor vehicle safety (seat belt use), and home safety
• Provide health advice or make a referral, as appropriate, to health education or counseling services aimed at reducing risk factors and includes chronic disease or diabetes self-management, weight loss, physical activity, smoking cessation, fall prevention, and nutrition counseling
• Assess psychosocial risks, such as depression, life satisfaction, stress, anger, loneliness/social isolation, pain, and fatigue
• Review your functional ability and level of safety
• Address your hearing impairment
• Review prescriptions, including use of opioids and dietary supplements
• Screen for potential substance use disorders
• Assess current plans for pain management
• Screen for cognitive impairment
• At your discretion, discuss advance care planning services
• Develop a screening schedule of preventive services and screening recommended for you

How is the Annual Wellness Visit different from a Routine Physical Exam?

Some people may be under the impression that an annual wellness visit and physical exam are one in the same. However, there is a clear distinction between them: while both services include collection of vital signs such as blood pressure or body mass index (BMI), only Annual Wellness Visit involve interviews with patients to check up on their general health status.

A physical exam, on the other hand, will likely involve bloodwork and other tests that may include checking for levels associated with an existing condition, such as the A1c test if you have type 2 diabetes or TSH levels if you have a thyroid disorder.

It doesn’t mean that bloodwork or extra testing won’t be done during your Annual Wellness Visit; however, if they are, they’ll be at a cost. It’s important to remember that the Annual Wellness Visit is FREE, while the physical exam and lab tests do come at a cost.

The provider may use the Annual Wellness Visit to spot where coordination of care with other specialists is needed. You may have ongoing back issues or arthritis, so he/she may note that you’re connecting with an orthopedic doctor or rheumatologist. An Annual Wellness Visit, however, may not be the place to resolve a new rash or prostate discomfort; though it may be taken into consideration to paint an overall picture of your health and written up as critical health concerns that need follow-up care.

In short, it’s up to you to decide if you want to get annual physical exams based on your health needs, coverage, and budget. However, it’s important to take advantage of your Medicare benefits and schedule a Medicare Annual Wellness Visit every year.

This visit is an important opportunity to proactively manage your health and catch any problems early on. So be sure to take advantage of it to continue to live a long, healthy, and fulfilling life!