Yearly Wellness Visit
If you’ve had Medicare Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update your personalized plan to prevent disease or disability based on your current health and risk factors. The yearly “Wellness” visit isn’t a physical exam. Medicare covers this visit once every 12 months.
Your provider will ask you to fill out a Health Risk Assessment as part of this visit. This will help you and your provider develop a personalized prevention plan to help you stay health and get the most out of your visit. Your visit may include: routine measurements, health advice, a review of your medical and family history, your current prescriptions, advance care planning and more.
Your provider will also perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, and making decisions about your everyday life. If your provider thinks you may have cognitive impairment, Medicare covers a separate visit to do a more thorough review of our cognitive function and check for conditions like dementia, depression, anxiety, or delirium and design a care plan.
Your provider will also evaluate your potential risk factors for a substance use disorder and refer you for treatment, if needed. If you use opioid medication, your provider will review your treatment plan, share information about non-opioid treatment options, and refer you to a specialist, as appropriate.
Your first yearly “Wellness” visit can’t take place within 12 months of your Part B enrollment or your “Welcome to Medicare” preventive visit. However, you don’t need to have had a “Welcome to Medicare” preventive visit to qualify for a yearly “Wellness” visit.
You pay nothing for the yearly “Wellness” visit if the doctor or other qualified health care provider accepts assignment.
If your doctor or other health care provider performs additional tests or services during the same visit that Medicare doesn’t cover under this preventive benefit, you may have to pay a coinsurance, and the Part B deductible may apply. If Medicare doesn’t cover the additional tests or services (like a routine physical exam), you may have to pay the full amount.