Questions and Answers About Medicare Annual Wellness Visits

An annual wellness visit is a yearly appointment with a healthcare provider that Medicare covers at no cost to you. Why should you get one, what does it cover and how is it different from an annual physical?

We spoke with UNC Health family medicine physician Rachael Hollifield, DO, and Jill Godfrey-Olson, MS, RN, manager of embedded care management at UNC Health, to learn more.

What is an annual wellness visit?

An annual wellness visit is a yearly visit with a healthcare primary care provider, who can be a nurse or a doctor, and/or a licensed social worker (often called a care manager). It includes a review of your medical and social history and is designed to help prevent illness based on your current health and risk factors.

The visit may include education or counseling about the following services:

  • Immunizations, including flu, shingles and pneumococcal vaccines
  • Height, weight and blood pressure measurements
  • A calculation of your body mass index
  • A review of your potential risk for depression and your level of safety
  • Referrals for other care, if needed
  • Certain screenings, such as mammograms, bone density scans, and dementia and depression screenings
  • A falls risk assessment
  • An opportunity to discuss creating an advance directive
  • A written plan letting you know which screenings, shots and other preventive services you need

Typically, your first annual wellness visit—which occurs after your 65th birthday—is more comprehensive. It may include labs and an electrocardiogram and will verify that you are up to date on vaccines. After your initial visit, you will continue to have yearly visits where you can discuss problems, concerns and other necessary screenings.

Who should get an annual wellness visit?

Anyone who is covered by Medicare federal health insurance should get an annual wellness visit. Typically, Medicare patients are 65 and older, but patients with disabilities who are younger than 65 may also be eligible.

Why should I have an annual wellness visit?

Annual wellness visits are a benefit provided by Medicare to patients at no cost to you. They are an opportunity for you to sit down once a year to review your medical history and discuss preventive care that can keep you from getting very sick or ending up in the hospital.

“What makes them unique is they do a really good job at closing some gaps that we may not close in our regular office visits, such as a dementia screening and a falls risk assessment,” Dr. Hollifield says.

Care managers also will review whether a patient needs additional help, such as assistance with meals or taking their medications. They also talk to patients about advance care planning, including living wills and advance directives.

“We help them get their medical wishes for their care documented and have a plan in place should they ever not be able to speak for themselves regarding their medical care and wishes,” Godfrey-Olson says.

How is an annual wellness visit different from a physical?

An annual wellness visit is not a head-to-toe physical. Instead, you usually sit down to discuss problems or concerns you have as well as preventive care to keep you healthy and out of the hospital.

The structure of an annual wellness visit allows more time for you and your care team to discuss concerns that you may not have time to talk about during your physical or other visits to your provider during the year. Most appointments last about 45 minutes.

The purpose of the annual wellness visit is to try to prevent future issues that could result if a problem isn’t addressed promptly.

“We are looking at risk factors for this population, making sure that the patients have what they need to keep them healthy and independent in the home as long as they’d like to be,” Godfrey-Olson says.

How much do annual wellness visits cost?

There is no cost. It is a benefit provided by Medicare to patients. Medicare will pay for an annual wellness visit once every 12 months. While a benefit to Medicare recipients, these visits are not required to keep your Medicare benefits.

How can I make the most out of my annual wellness visit?

It’s a good idea to prepare for your annual wellness visit to make sure you cover everything and stay on task. Bring a complete list of your medications, including vitamins, supplements and over-the-counter medication, for your provider to review. You also can put all your medication bottles in a bag to bring.

“You should bring a list of top concerns or questions, as well as be prepared to discuss your medical history, including chronic illness and any past surgeries,” Godfrey-Olson says. “This visit is intended to help you take control of your health and prevent future problems, and your care team is there to assist with that.”

Eligible for an annual wellness visit? Contact your doctor. Don’t have one? Find a doctor near you.