Medicare insurance pays for visits with your primary care provider or nurse to review preventive services and develop a personalized care plan to keep you healthy.
Types of Medicare Wellness Visits
There are three types of preventive services visits for Medicare patients. When you first join Medicare, you will have a Welcome to Medicare exam with your doctor that includes the required criteria from Medicare. One year after joining Medicare, you will have another wellness visit they call the Annual Wellness visit. For each year after that, Medicare requires an annual wellness visit that has a checklist of health measures they require.
| Welcome to Medicare / Initial Preventive Physical Exam (IPPE) | One-time visit for patients new to Medicare, required within 1s year after enrollment. |
| Initial Annual Wellness Visit | A one-time visit with your provider at least one year after the “Welcome to Medicare” exam. |
| Annual Wellness Visit | Annual visit |
Is the MAWV a routine physical?
Although it sounds similar, the Medicare Annual Wellness Visit is not the same thing as a yearly physical exam. The Medicare Annual Wellness Visit focuses on gathering your health information, counseling on improving your health, and preventing complications from current illnesses. Your provider must adhere to very specific requirements about what the “Medicare Annual Wellness Visit” offers.
New Medicare recipients visit their primary care doctors to get a Health Risk Assessment and a personal care plan. The MAWV follows up on this initial list and reviews the care plan to make sure it is still on track. MAWV questions might include whether you need help dressing or bathing, if you have had a fall, and if you feel safe at home. The visit may not include all the elements of a routine physical. The specifics of a MAWV are regulated by Medicare.
What happens during a MAWV?
MAWVs include a comprehensive review of the patient’s medical and social history. The healthcare provider will ask questions about the patient’s lifestyle, habits, diet, and any recent changes in physical health or mental status. This information helps the provider identify any potential health risks and provide care recommendations.
During the appointment, the provider will also review any immunizations that the patient may need, as well as current medications, and screen for certain conditions such as depression, diabetes, and high blood pressure. During the visit, you can expect your healthcare provider to include the following:
- check your height, weight, and vital signs such as blood pressure,
- perform a health risk assessment,
- review your functional abilities,
- discuss preventive screenings,
- update records to reflect your current healthcare providers and services,
- discuss your medical history,
- provide health education and preventive counseling service referrals as needed
- create a personalized prevention plan to help you stay healthy.
This information can be used to identify any potential health risks and provide preventive care, such as vaccinations, counseling, and lifestyle changes. During the appointment, the provider will also discuss any recommended preventive services that may be necessary for the patient’s health. These may include screenings for cancer or other conditions. The provider may also recommend lifestyle changes such as exercising, eating a balanced diet, or quitting smoking.
What is the cost?
The Medicare Annual Wellness Visit is a 100% covered benefit by Medicare insurance. However, many doctors and providers combine the MAWV with an annual physical exam that may be subject to a copay, depending on your Medicare plan. Patients may receive referrals for other medical services, including lab work or diagnostic appointments. These are not, however, included in the MAWV.
A personalized care plan
Patients who take advantage of this Medicare benefit will work with their healthcare team to create a personalized prevention plan. Medicare Annual Wellness Visits (MAWV) are an important part of preventive healthcare for Medicare patients. The visit is an opportunity for you and your healthcare provider to assess medical problems, address health concerns, and plan preventive services that may help maintain or improve your health.
If you are new to Medicare, talk to your doctor about scheduling your “Welcome to Medicare” visit to get started!