Staying healthy as you age: Medicare Annual Wellness Visits explained

Getting older has many advantages. You have the wisdom that comes with experience, plenty of stories to share and are usually more comfortable with who you are. If you have Medicare Part B coverage, another benefit is that you qualify for an Annual Wellness Visit.

This visit aims to keep you healthy and give you the tools to have a good quality of life as you age. The Medicare Annual Wellness Visit allows your health care team to review your health status, design a personalized prevention plan and connect you with critical preventive services covered by Medicare Part B.

Medicare Annual Wellness Visits create a snapshot of your health and provide a reference point for future visits. This improves the chances that a potentially serious health issue is caught early.

It's important to understand that Medicare Annual Wellness Visits differ from a physical exam conducted by your primary care provider.

Here are three major differences between these types of appointments:

1. Provider seen

A nurse or nurse practitioner typically conducts a Medicare Annual Wellness Visit. In most cases, you will not see your primary doctor or health care provider during this appointment.

A physical exam is conducted by your primary care provider, who may be a doctor, nurse practitioner or physician assistant.

2. What's included

A Medicare Annual Wellness Visit is meant to enhance your health and focuses on your well-being through interviews and assessments of your lifestyle factors. You will also be asked to fill out a health risk assessment before your appointment.

During a Medicare Annual Wellness Visit, the nurse will:

• Evaluate your fall risk.
• Measure your height, weight and blood pressure.
• Offer referrals to other health education or preventive services.
• Provide information related to voluntary advance care planning.
• Screen for cognitive impairments like dementia.
• Screen for depression.
• Update your medical and family history.

A physical exam includes an age and gender-appropriate comprehensive head-to-toe checkup. This exam is completed to detect and prevent illnesses or injuries.

During a physical exam, your primary care provider may:

• Check your vital signs.
• Discuss acute or urgent health issues.
• Review chronic health conditions.
• Review your medications.
• Perform a physical exam.
• Ask about your activity level, relationships and home environment.

3. Frequency and cost

A Medicare Annual Wellness Visit can be scheduled after you have Medicare Part B coverage for at least 12 months and each year after that. Subsequent visits must be at least 365 days, or one full year, after your previous year's visit. Medicare offers the Annual Wellness Visit at no cost for those who have Medicare Part B coverage.

A physical exam can be scheduled at any time. You or your insurance carrier will be responsible for the cost of this exam. The total will vary based on what tests and services are completed during the visit. Ask your insurance carrier for coverage details.

Medicare Annual Wellness Visits and physical exams are best scheduled for the same day, with the wellness visit occurring first. Contact your health care team and ask if you qualify for a Medicare Annual Wellness Visit.

Robert Stroebel, M.D., is a Community Internal Medicine, Geriatric and Palliative Care physician at Mayo Clinic Primary Care in Rochester and Kasson, Minnesota.