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Every year Medicare Part B users are allowed to get a Medicare Annual Wellness Visit (AWV)—a nonphysical check-up that allows them and their medical provider to create a personalized prevention plan. The exams aren’t meant to be scary, but as with any medical appointment, worries and questions can arise. That’s why we sat down with a top Medicare expert to learn what Medicare Part B users need to know to prepare for their exam and provide details on how they can get the most out of the visit. Read on for more.
What to expect from your Medicare Annual Wellness Visit
A Medicare Annual Wellness Visit is different from your annual checkup. Whitney Stidom, vice president of consumer enablement at eHealth, an online health insurance marketplace, explains, “This wellness visit is not a physical exam. Rather than providing preventive medical care and tests, this visit is focused on reviewing the patient’s personal and family medical history and their current prescriptions.”
“The doctor may also lay out a schedule for future preventive medical screenings and may offer personalized medical advice,” she continues. “A cognitive assessment may also be conducted to see if there are any signs of impairment, including potentially identifying early stages of dementia or Alzheimer’s disease.”
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To qualify for the visit, you must be enrolled in Medicare Part B for at least 12 months. And if that’s you, Stidom heavily advises you contact your primary care doctor to set up an appointment.
“An annual wellness visit is one of the most valuable benefits included with most insurance health plans, including Medicare,” she explains. “Yet a recent survey found 20 percent of Americans don’t typically get an annual wellness exam, and about the same percentage don’t know an annual wellness exam is covered at no additional cost under most insurance plans when people use an in-network care provider.”
How much does a Medicare Annual Wellness Visit cost?
As long as you go to a doctor who accepts Medicare, there shouldn’t be any cost for your Medicare Annual Wellness Visit, says Stidom.
“However, if diagnoses are made or other tests and services are performed outside the scope of the wellness visit, these may incur out-of-pocket costs for some patients,” she continues. “Medicare beneficiaries should always feel free to ask their physicians during the visit which services might result in out-of-pocket costs for them.”
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How to prepare for your Medicare Annual Wellness Visit
To help make your visit as easy as possible, Stidom recommends bringing a list of your current prescription medications and dosages, adding, “It’s important to give the doctor the most accurate picture possible of your personal and family history and your prescription drug use. If helpful, bring notes describing these.”
And while many people try to prepare for the cognitive exam, Stidom notes, “There’s no need to study or prepare beforehand for the cognitive assessment. During the assessment, the doctor will typically ask some simple questions and perform some basic memory tests. For example, the person might be asked to draw a picture of a clock showing a certain time, or to remember certain words and repeat them after a short period of time.”
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What preventive screenings should Medicare patients prioritize after their wellness visit?
After your Medicare Annual Wellness Visit, Stidom says it’s important to prioritize a select few preventive screenings.
“Blood pressure and cholesterol checks, diabetes screening for those with an elevated body mass index (BMI) and lung cancer screening for adults ages 55 to 80 with a history of heavy smoking,” she says. “It’s also important for women to get mammograms every 1 to 2 years starting at age 40 and cervical cancer screenings up to age 65, plus colorectal cancer screenings if you are 50 to 75 years old and prostate cancer exams for men, based on your doctor’s recommendation.”
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