Medicare Annual Wellness Visits
Medicare Annual Wellness Visit vs. Annual Physical
Annual Wellness Visits (AWV) and annual physicals play a crucial role in patient healthcare, yet they are frequently confused due to their similar names. However, these two services vary significantly. While a physical entails a comprehensive examination along with a wellness evaluation, an Annual Wellness Visit is exclusively centered around a patient’s responses to a health risk assessment, typically excluding any lab work or tests that involve physical contact.
Read on to gain a deeper understanding of Annual Wellness Visits and how they can be enhanced for a superior patient and provider experience.
Yearly “Wellness” visits
If you have been enrolled in Medicare Part B (Medical Insurance) for over 12 months, you are eligible for a yearly “Wellness” visit. This visit is intended to create or update your personalized plan aimed at preventing disease or disability, considering your current health status and risk factors. It’s important to note that the yearly “Wellness” visit is not a physical examination.
Your initial yearly “Wellness” visit cannot occur within 12 months of your enrollment in Part B or your “Welcome to Medicare” preventive visit. However, having a “Welcome to Medicare” preventive visit is not a prerequisite to qualify for a yearly “Wellness” visit.
Your costs with Medicare
This visit comes at no cost to you if your doctor or other healthcare provider accepts the assignment. The Part B deductible does not apply to this visit. However, if your doctor or other healthcare provider performs additional tests or services during the same visit that are not covered by Medicare under this preventive benefit, you may be required to pay coinsurance, and the Part B deductible may apply.
It’s important to note that if Medicare does not cover the additional tests or services (such as a routine physical exam), you may be responsible for paying the full amount. Always check with your healthcare provider and insurance to understand what costs may be associated with additional tests or services.
What it is
During your yearly “Wellness” visit, your provider will ask you to complete a “Health Risk Assessment” questionnaire. Your responses to these questions will assist both you and your provider in creating a personalized plan to maintain your health and maximize the benefits of your visit. The visit may include the following components:
1. Routine measurements: This includes metrics such as your height, weight, and blood pressure.
2. Medical and family history review: Your provider will go through your past medical records and your family’s health history.
3. Current prescription review: Your provider will review all the medications you are currently taking.
4. Personalized health advice: Based on the information gathered, your provider will offer personalized advice to help maintain or improve your health. 5. Advance care planning: Your provider will discuss with you the kind of care you would want if you become seriously ill or nearing the end of life.
Your provider will also conduct a cognitive assessment to detect signs of cognitive impairment, such as dementia or Alzheimer’s disease. Signs of cognitive impairment include challenges with memory, learning new information, concentration, managing finances, and making everyday life decisions. If your provider suspects you may have cognitive impairment, Medicare covers a separate visit for a more comprehensive review of your cognitive function. This visit also includes checking for conditions like dementia, depression, anxiety, or delirium and designing a care plan.
Note Should you have an existing opioid prescription, your healthcare provider will conduct a thorough assessment of your potential risk factors associated with opioid use disorder. They will evaluate your pain level, examine your current treatment strategy, and discuss alternative, non-opioid treatment options. If necessary, you may be referred to a specialist. Additionally, your provider will assess any potential risk factors you may have for substance use disorder, and if required, recommend suitable treatment services.
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