Medicare checklist: Annual Wellness Visits

At The Polyclinic, we want to keep you healthy, out of the hospital and doing what you love. We believe in preventive care, which helps stop illness before it starts. One great way to stay healthy is to take advantage of the preventive visits covered by Medicare.

There are two kinds of Medicare appointments you should know about:

• Welcome to Medicare visit
• Annual Wellness Visit (AWV)

These appointments aren't the same as a traditional physical exam you usually have every year with your doctor. These appointments are covered by Medicare and help you get important care.

Welcome to Medicare visit

As the name suggests, Medicare covers your Welcome to Medicare visit once within the first 12 months you have Medicare Part B.

Medicare Advantage plans cover the same preventive services as Original Medicare when you see network providers, including your designated primary care provider. During this first visit, your doctor will:

• Review your current prescriptions
• Review your health and medical history
• Check your height, weight and blood pressure
• Find out your body mass index (BMI)
• Do a simple vision test
• Find out information about depression and other mental health problems
• Talk about how to stop illness before it starts
• Talk about health and wellness improvements

After your doctor goes over the list above with you, your doctor will share a personalized care plan with you. This plan will have recommendations for screenings, immunizations and other preventive services.

You will be billed separately for any services or screenings not covered by Medicare, so any other health concerns may require a separate follow-up appointment.

After your Welcome to Medicare visit, you’ll start having an Annual Wellness Visit (AWV) to review your health. This yearly appointment also focuses on how to take care of your medical problems so they don't get worse.

You can get an AWV every 12 months if you have been enrolled in Medicare Part B longer than 12 months.

What to bring to your appointment

When you come to your appointment, always bring:

• Medical and immunization (shots) records from outside providers
• Your family health history
• A list of your prescriptions and over-the-counter medications, including supplements

Different than the usual physical exam

The traditional annual physical is an exam that usually checks your:

• Vital signs
• Heart
• Lungs
• Head
• Neck
• Stomach area
• Reflexes
• Skin

A wellness visit is considered a “hands-off” visit and usually looks at your:

• Self care
• Health history
• Age-appropriate screenings
• Education on disease management
• Chance of having a medical problem

During this visit, your doctor will:

• Update your medical history, including a list of your providers and prescriptions
• Talk about how to stop illness before it starts
• Talk about health and wellness improvements
• Check your height, weight and blood pressure
• Review your personal plan of care, including what health screenings are paid for by Medicare

With Medicare, you can also get many free preventive care services, such as screenings for heart disease, prostate cancer screenings for men and mammograms, which check for breast cancer.

When to schedule your AWV

What your insurance plan covers depends on timing and your plan. While annual physical exams aren't covered by Medicare, both traditional annual physicals and wellness visits are covered by most Medicare Advantage plans.

If you have Original Medicare Part B with or without a supplement plan, you should schedule your AWVs one full year apart to make sure your insurance will pay for the visit.

Medicare Advantage plans also cover one AWV every 12 months. Exceptions may apply, however, so be check with your insurance plan before you schedule your appointment.

Contact The Polyclinic Population Health Team at 1-206-860-5510, Monday through Friday, 8 a.m. to 5 p.m. We'll help you understand and schedule your wellness and preventive visits if you're on a Medicare, Medicare Supplement or Medicare Advantage plan.

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.