What You Need To Know About Medicare Wellness Visits

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medicare annual wellness

Did you know that if you receive Medicare, you are eligible for a no-cost annual wellness visit? Medicare annual wellness visits focus on health promotion and disease prevention, which is key to living a long, healthy life.

What is a Medicare Wellness Visit?

The Medicare wellness visit is a covered visit that allows your health care provider to dedicate time for a health risk assessment and prevention/screening strategies. During this visit, your health care provider will go over your health risks, prevention and screenings only – giving your provider the time needed to make sure all of your immunizations, cancer screenings and personal screenings based on risk are discussed and scheduled.

Your physician will conduct a health risk assessment and create a five to 10-year personalized health plan that promotes health and prevents disease. The visits give you the opportunity to ask questions and get in-depth information.

The Medicare wellness visit is not a comprehensive physical exam. But if you have a certain Medicare Advantage Plan, you can schedule a physical exam and a wellness visit for the same appointment with your provider

Who Is Eligible?

People who are age 65 and older with Medicare insurance are eligible for the Medicare annual wellness visit, as are people who are younger than age 65 with disabilities with Medicare insurance.

There are three type of wellness visits:

  • The initial preventive physical exam (IPPE)– made within 12 months of your Medicare enrollment
  • The initial annual wellness visit – these take place 11 full calendar months since the IPPE or if you’ve never had an IPPE and you’ve had Medicare coverage for more than 12 months.
  • Subsequent annual wellness visits – these take place 11 full calendar months since the last annual wellness visit.

It’s important to ask to schedule an annual wellness visit when you make your appointment. That way, you can make sure Medicare covers the visit as a preventive service.

However, if your visit identifies other needed services or you request that your physician address other acute health issues during the visit, cost-sharing may be necessary. Be sure to discuss any questions with your physician’s office in advance of your visit.

What to Expect During the Annual Wellness Visit

Your health care provider will do these things at your visit:

  • Review your blood pressure, heart rate, height, weight and body mass index (BMI).
  • Review your current health problems, as well as your medical, surgical, family and social histories.
  • Review your current medications
  • Conduct a health risk assessment
  • Provide nutrition counseling
  • Discuss an exercise plan to fit your lifestyle
  • Discuss smoking cessation and arrange for counseling if needed
  • Discuss fall prevention
  • Discuss advance care planning
  • Discuss preventive screenings recommended by evidence-based practice guidelines that are indicated for you based upon your age, risk factors and family history

How To Prepare for a Wellness Visit

Bring these items to your visit:

  • Immunization records
  • List of current prescribed medicines, supplements and over-the-counter medicines
  • List of your patient care team – any specialists you see for care
  • List of your questions

In addition, be prepared to review your family medical history.

Jennifer Gaietto, CNP, is a Certified Nurse Practitioner and a Westside Wellness Program Provider

Related Links

At University Hospitals, we believe that good health starts with great primary care. Learn more about primary care at University Hospitals. 

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