Medicare wellness exam: a brief overview

Once a year, Medicare provides enrollees with the benefit of a free annual wellness visit. This exam is just an in-person meeting with their health care team. It’s aimed to discuss and evaluate a person’s current health condition. And steer their focus towards health maintenance and disease prevention. Individuals qualify for the Annual Wellness Visit after having Medicare Part B for 12 months.

The primary purpose of a Medicare wellness visit is for a professional health care team to review the member’s overall health. Upon reviewing it, they create a prevention health plan tailored to the enrollee’s specific condition. Medicare feels these exams reduce the number of trips to the doctor’s office. 

A Medicare wellness exam should not be confused with an Initial Preventive Physical Examination (IPPE). This is only available during the first 12 months of enrollment in Medicare Part B.

What to expect in an annual wellness visit by Medicare? 

Medicare invests in these visits to keep its members healthy. It can set members up on a new and improved personalized preventive health plan. It considers medical history as well as current medical conditions. It also discusses issues related to referrals and private practitioners. And tries to provide the best solutions available. 

Here’s what you can expect in an annual wellness exam.

A discussion with the provider about your health

During the wellness visit, the member fills in a Health Risk Assessment Questionnaire. The provider may then take a look at current prescription drugs, review family history, discuss daily activities, habits, and lifestyle in general. This helps the doctor better understand the member’s current health needs so they can create a prevention plan to eliminate health risks.

Taking measurements of the patients, including: 

• Height
• Blood Pressure
• Body Mass Index 

Other tests:

• Risk factors for depression
• Cognitive function assessment
• Functional ability and safety

How to make the annual wellness exam easy?

To make the annual wellness exam quick and easy, make sure to have the following information handy for the visit. First, info about vaccinations received, along with prior surgery and treatment dates. Be sure to include any vaccines received at different practices. 

Include information about all medical specialists seen. This list can include cardiologist, OB/GYN, urologist, etc. Apart from that, make sure to have prescription supplements and any other over-the-counter medications with you. And have them in their original containers. 

Is Medicare wellness exam a waste of time? 

Considering the number of benefits a member can get from these visits, it’s safe to say they’re not a waste of time. It’s a chance for patients to sit with their physicians once a year and review their medical history and preventive care strategies. All of this comes at no cost.

However, some patients are unhappy about their wellness visit. Mostly because they expected it to be something it’s not. A wellness visit is not a physical or a sick visit. There’s not a detailed medical exam or discussion of treatment plans. Patients are disappointed to learn the wellness visit is just a conversation about their overall health, lifestyle, and family history. Wellness visits do not include specific health issues.

Physical exam vs. wellness exam

Unlike a wellness visit, Medicare does not cover an annual physical exam. Medicare’s annual wellness visits are yearly checkups for preventive purposes. During this visit, the patient fills out a health risk assessment form. The doctor then uses the form to assess any risk factors and schedules any additional tests or preventive measures they feel are necessary. 

On the other hand, a routine physical offers a more thorough check of the current health condition. During this type of physical, the doctor touches, looks, and feels the parts of the patient’s body. In short, a Medicare wellness visit is a conversation. A physician is hands-on during a routine physical exam. 

What a Medicare wellness visit is not

Wellness visits do not:

• Diagnose and treat specific conditions (new or chronic). A patient must schedule a separate appointment if they need medical help regarding a specific problem. Such as having a cold and not feeling well or issues with getting severe headaches.
• Perform any medical tests (lab tests or X-ray).
• Prescribe new prescription drugs.
• Make any changes to a current treatment plan.

Can you refuse a Medicare wellness visit? 

Yes, you can refuse a Medicare Annual Wellness Visit. It’s not mandatory for Medicare enrollees to participate in this visit even though most benefit from it.

Since Medicare Wellness Visits are voluntary, they do not have any impact on Medicare coverage. And there’s no penalty for not having one. 

Final thoughts

Medicare wellness exams can be insightful, revealing, and even life-saving visits to the doctor’s office. Most of the time people delay their health checkups until their condition gets extremely bad. 

For this reason, it’s important to take precautions and talk about your health with a specialist. Even if you feel you don’t need to. Using this free-of-cost opportunity provided by Medicare can be the best thing you do for prevention.