Annual Wellness Visit
A yearly Medicare prevention visit to review your health risks and plan screenings, with similar preventive checkups offered by most other health plans.
Last revised
Key takeaways
- Who is eligible: people who have had Medicare Part B for more than 12 months
- Interval: once every 12 months
- Most useful single change: Book it each year; you usually have to ask for it.
- Commonest mistake: Skipping it because you feel well; that is the point of it.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
It exists specifically to find the conditions that have no symptoms yet, and many eligible people never book one.
The numbers, in one place
| Measure | Figure |
|---|---|
| Who is eligible | people who have had Medicare Part B for more than 12 months |
| Interval | once every 12 months |
| Covers | a health risk assessment, blood pressure, weight, a medicine review, a cognitive check and a screening schedule |
| Cost | no copay or deductible when the provider accepts assignment |
| Not on Medicare | ask your health plan about a yearly preventive checkup |
What helps
- Book it each year; you usually have to ask for it
- Ask for your 10-year cardiovascular risk estimate and what it means
- Bring a list of your medicines, supplements and any family history
- Leave with a written schedule of the screenings that are due
What to avoid
- Skipping it because you feel well; that is the point of it
- Treating it as a full physical exam; it is a prevention-planning visit
- Ignoring follow-up appointments after an abnormal result
In depth
The Medicare Annual Wellness Visit is built around a simple idea: most of the conditions that shorten life or reduce independence develop quietly for years before they cause symptoms. High blood pressure, early memory changes, rising blood sugar, falls risk and several cancers can all be found or anticipated long before they announce themselves. The visit sets aside time to look for them deliberately, rather than squeezing prevention into an appointment booked for something else.
It is different from the head-to-toe physical exam many people picture. The core of the visit is a conversation and a plan. You complete a health risk assessment, usually a questionnaire about your habits, mood, safety at home, daily activities and any help you need. Your clinician then reviews your medical and family history, the medicines you take, and the other providers who look after you, and uses that to build a personalized prevention plan for the coming years.
Medicare also offers a one-time "Welcome to Medicare" preventive visit within the first 12 months of Part B, after which the yearly wellness visit takes over. People with employer, marketplace or Medicaid coverage usually have a comparable yearly preventive visit, because most US health plans must cover recommended preventive services without cost-sharing when you use an in-network provider. The details vary by plan, so it is worth checking what yours calls the visit and what it includes.
Causes and risk factors
- Being newly eligible after more than 12 months of Medicare Part B
- Having several long-term conditions or many medicines that need reviewing together
- A family history of heart disease, diabetes, cancer or dementia
- Changes in memory, mood, hearing, vision or balance that you or family have noticed
- Living alone or needing more help with daily tasks than before
- Having gone a long time without any preventive care
How it is checked
During the visit your clinician measures your height, weight, blood pressure and other routine measurements, and checks for signs of cognitive impairment through observation, your own report and sometimes a short structured test. They review your risk of depression, your ability to manage everyday activities, and your home safety, including falls risk. They also review any opioid prescriptions and screen for substance use, and may offer to discuss advance care planning, which means recording your wishes about future medical care.
The result is a written screening schedule, often covering the next five to ten years, listing which tests and vaccines are due and when. If your clinician orders extra tests or treats a new problem during the same appointment, that part may be billed separately and a copay or deductible can apply. Asking at the start which parts are preventive and which are not helps avoid surprise bills.
Related topics
- Medicare Wellness Visits: What the Evidence Actually Says (Medicare and Medicaid)
- What the Guidance Really Says About Men and Health Services (Men's Health)
- No-Cost Preventive Care: What the Evidence Actually Says (Health Insurance and Costs)
- What the Guidance Really Says About Annual Reviews (Long-Term Conditions)
Where to go next
- A Q and A on Annual Wellness Visit
- Annual Wellness Visit at a Glance
- Preventive Care: The Complete Guide
- The Evidence on Cancer Screening Recommendations, Without the Hype
- What the Guidance Really Says About Blood Pressure Checks
When to get help
Do not wait for a wellness visit if you have symptoms. Call 911 for chest pain lasting more than a few minutes, sudden weakness on one side, or difficulty speaking. See your doctor promptly for unexplained weight loss, a persistent cough, blood in urine or stool, or a new lump.
Where this comes from
- Medicare.gov — Yearly "Wellness" visits
- CMS — Medicare Wellness Visits
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.