Annual Wellness Visit FAQ

Under the Affordable Care Act (the health care reform law), Medicare will now pay for an annual wellness visit, which will include the creation of a personalized prevention plan and detection of possible cognitive impairment. This new benefit began on January 1, 2011.

1. What does the Annual Wellness Visit cost?

You pay nothing out of pocket for this visit. However, you may incur a copay or deductible expense if additional testing is required.

2. When am I eligible for my Annual Wellness Visit?

After you have had Medicare Part B for more than 12 months. If you've had a "Welcome to Medicare Visit" within the last 12 months, you must wait 12 months to schedule your Annual Wellness Visit.

3. What if I'm sick? Can I schedule my sick visit and Annual Wellness Visit at the same time?

It will depend on the severity of the illness and your doctor's schedule but may be possible. However, you will be charged for a sick visit at that time.

4. How often can I have my Annual Wellness Visit?

You may have an Annual Wellness Visit once every 12 months.

5. What is covered during the new Annual Wellness Visit?

Your first Annual Wellness Visit will include:

• routine measurements such as height, weight, blood pressure and body-mass index;
• review of medical and family history;
• establishing a list of current providers, suppliers, and medications;
• a personal risk assessment (including any mental health conditions);
• a review of functional ability and level of safety;
• detection of any cognitive impairment;
• screening for depression;
• establishing a schedule for Medicare's screening and preventive services you qualify for over the next 5 to 10 years;
• other advice or referral services that may help intervene and treat potential health risks;
• voluntary advanced care planning.

Subsequent Annual Wellness Visits will include:

• measurement of weight, blood pressure, and other measurements deemed appropriate;
• an update to medical and family history;
• an update to the list of providers, suppliers, and medications;
• a review of the initial personal risk assessment;
• detection of any cognitive impairment;
• an updated screening schedule; and,
• a review and update to list of referral services to help intervene and treat potential health risks.

6. Is the Annual Wellness Visit the same thing as an annual physical exam?

No. An annual physical is a much more extensive physical examination. In addition to collecting a medical history, it may also include: Vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, dermatological exam, and extremities exam. The Annual Wellness Visit should not replace your annual physical.

7. Will I actually see a doctor during the Annual Wellness Visit?

You will see your primary care provider which could be a physician, nurse practitioner or physician assistant. However, most of your time may be spent with an allied health profession, such as a nurse or medical assistant who will gather most of your medical history so that your physician can determine an appropriate preventive health screening plan.

9. When am I eligible for my "Welcome to Medicare Visit?"

Medicare covers a one-time "Welcome to Medicare Visit" within the first 12 months you have Medicare Part B. If you did not receive your Welcome to Medicare Visit and have been with Medicare for more than 12 months, you are eligible for your Annual Wellness Visit.

10. What does the Welcome to Medicare Visit cost?

Beginning January 2011, you pay nothing out of pocket for this visit.