Understanding the Medicare wellness visit

A Medicare wellness visit is an opportunity to have a personalized conversation with your provider about your health and wellness, free of cost. During this annual visit, your provider will have you complete a "Health Risk Assessment" questionnaire. This will help you and your provider create a personalized wellness plan to keep you feeling your best throughout the year.

Common Questions

You're eligible for a free wellness visit every year after you've had Medicare Part B for longer than 12 months.

Not exactly. A Medicare wellness visit is all about talking to your provider and working together to create a personalized plan to stay healthy in the coming year. If you're concerned about a specific health issue or if you need a hands-on examination, a routine physical exam is necessary

Use the chart below to review the definition and differences between these two types of visits so you know what to expect and which is best for your current needs.

 

Medicare wellness visit

Routine physical exam

overview
Overview

Conversation-based consultation focused on prevention and determining a personalized wellness plan.

"Head-to-toe" physical examination that also includes a lengthy discussion of your health, history and risk factors.

cost
Cost

Free of charge to patients with Medicare Part B and all replacement plans.

100 percent out of pocket for Medicare Part B patients.

what's included
What's included

The visit is primarily conversation-based. It only includes:

  • Medical and family history review.
  • Detection of cognitive impairment.
  • Collection of health stats, including height, weight, blood pressure and other routine measurements.
  • Development of personalized wellness plan and screening checklist.

This visit includes a comprehensive, "head-to-toe" physical examination in addition to the elements included in a wellness visit.

counsel
Counsel

Provider can only provide counsel on mandatory screening checklist for prevention services that are covered by Medicare.

Provider can counsel patient on risk reduction, prevention of illnesses, order screening tests, and more.

Documentation requirements
Documentation requirements

Strict requirements regarding documentation. Make sure to ask your provider what is needed.

No strict documentation guidelines.