You had your Medicare checkup last spring. The doctor checked your blood pressure and your weight, asked how you were feeling, and said everything looked fine. The whole thing took about ten minutes. You left with nothing new and a vague feeling that you could have gotten more out of it if you had known what to ask.
That experience is common. The Medicare Annual Wellness Visit, sometimes called an annual medicare wellness visit or medicare annual checkup, is one of the most underused benefits in your coverage, partly because most patients do not know what it is supposed to include, and partly because doctors do not always have time to explain it. If you walk in without a list of questions, you often walk out with not much more than you came in with.
This post explains what the Medicare Annual Wellness Visit actually covers, what it does not cover, and exactly what to ask for while you are there.
What Is a Medicare Annual Wellness Visit?
The Medicare Annual Wellness Visit, often called the AWV, is a free yearly appointment covered under Medicare Part B. It is available to anyone enrolled in Medicare Part B who has had their coverage for longer than 12 months. The main Medicare Annual Wellness Visit requirement is that 12-month enrollment period. There is no additional eligibility step and no separate application to complete.
The purpose of the visit is prevention and planning, not treatment. Your doctor reviews your health history, assesses your current risks, screens for common conditions like depression and cognitive decline, and works with you to put together a written prevention plan. The Medicare Annual Wellness Visit is designed to catch things early and make sure you are using all the care you are entitled to.
There is no copay and no deductible for the Annual Wellness Visit itself. It is completely free. There is one important caveat that catches a lot of patients off guard: if you bring up a new health problem during the visit and your doctor addresses it, they may bill that as a separate office visit, which does carry the usual Part B cost sharing. Knowing this in advance helps you decide what to raise during the Annual Wellness Visit and what to save for a follow up appointment.
What Is Covered in a Medicare Annual Wellness Visit?
More than most patients realize. The visit covers a review of your medical and family history, a list of your current medications and supplements, measurements of your blood pressure, weight, height, and body mass index, and an assessment of your risk for depression using a standardized screening tool.
It also includes a cognitive assessment, which checks for early signs of memory loss or cognitive decline. This is not a lengthy test. It is a brief structured conversation. If anything concerns your doctor, they can follow up with a more thorough evaluation.
Your doctor will assess your risk of falling and screen for any difficulties with daily activities like bathing, dressing, or getting around safely at home. They will also review what preventive screenings you are due for, such as a bone density scan, a colorectal cancer screening, or a mammogram, and make sure those are on your schedule.
At the end of the visit, your doctor should give you a written prevention plan that summarizes your current health status, your risk factors, and the recommended next steps for your care. If you do not receive one, ask for it before you leave.
What Is Not Covered in a Medicare Annual Wellness Visit?
The Medicare Annual Wellness Visit does not include:
- A physical exam
- Diagnosis or treatment of existing symptoms
- Lab work as part of the visit itself
Those things belong in regular office appointments, which do have cost sharing.
Lab work can sometimes be ordered at the same appointment and may be covered by Medicare, but it is billed as a separate service rather than included in the Medicare Annual Wellness Visit itself. Ask your doctor before the appointment which labs Medicare will cover and which may come with a cost.
If you have symptoms that need attention, schedule a separate appointment to address them, or be aware going in that bringing up a new problem during your Medicare Annual Wellness Visit may add a charge to the visit.
Medicare Annual Wellness Visit Checklist: What Should I Ask For?
This is the part most patients skip, and it is the most valuable part of the visit. Use this checklist before you go, and bring it with you.
- Ask whether you qualify for Chronic Care Management. If you have two or more ongoing conditions, diabetes, high blood pressure, heart disease, COPD, depression, or others, you very likely qualify for a Medicare benefit that gives you a dedicated monthly care coordinator. Most patients who qualify have never been told.
- Ask about Behavioral Health Integration if you have been dealing with depression, anxiety, or another behavioral health concern alongside a physical condition. BHI adds structured mental health support to your existing care team and is covered under Medicare Part B.
- Ask about Community Health Integration if you face practical barriers to managing your health: getting to appointments, affording recommended food, or feeling socially isolated. CHI is a Medicare benefit available since 2024 that covers support for exactly those kinds of problems.
- Ask about your depression screening results and what the follow up plan is. Research shows fewer than one in three older adults who screen positive for depression during a wellness visit receive any follow up. If your screening flagged anything and nothing was recommended, ask what happens next.
- Ask what preventive screenings you are due for and when to schedule them. Bone density, colorectal cancer screening, and mammograms are commonly missed.
- Ask for a full medication review if you take more than two or three medications. Ask your doctor whether all of them are still necessary and whether any interact with each other.
- Ask whether your specialists are communicating with your primary care doctor, and whether Chronic Care Management could help coordinate that.
You do not need to raise all of these in a single visit. Two or three specific questions, written down in advance, will change what you leave with.
How Often Can I Have a Medicare Annual Wellness Visit?
Once every 12 months. If you are new to Medicare and have had your Part B coverage for less than 12 months, you may be eligible for a one time Welcome to Medicare preventive visit, also called the Initial Preventive Physical Examination. This is a separate visit for new beneficiaries and is also covered at no cost.
After that first visit, the Medicare Annual Wellness Visit is available every year. Setting a consistent time each year, the same month, around a birthday or another fixed date, makes it easier to stay on schedule.
How POD Health Can Support Your Medicare Annual Wellness Visit
POD Health provides care coordination for Medicare patients across New York City, Westchester County, Florida, and Colorado. If you want help preparing for your Medicare Annual Wellness Visit, or if you would like to know which care coordination programs you qualify for, such as Chronic Care Management, Behavioral Health Integration, or Community Health Integration, the POD Health team can walk you through it. Contact us today.
