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Medicare Annual Wellness Visit vs annual check-up: What’s the difference?

Senior woman reading a book - Medicare Annual Wellness Visit, adult checkups
Schedule your Annual Wellness Visit each year.

You are probably familiar with the concept of a yearly check-up. It may be surprising to learn that before the Affordable Care Act, Medicare didn’t officially cover a yearly check-up. The good news is Medicare now covers something similar – an Annual Wellness Visit.

“The Medicare Annual Wellness Visit has some unique qualities compared to traditional checkups for the non-Medicare population,” said Dr. Sumeet Goel, a Marshfield Clinic Health System family medicine physician.

Preventive health needs change with age

The Medicare Annual Wellness Visit typically consists of a general health questionnaire, which looks for issues with memory, mental health, safety, nutrition or social supports. Your provider also reviews your medical history, medication list and ensures preventive services are up-to-date.

Sometimes this visit is even completed without physically seeing your primary care provider,” Goel said. Your provider works with your health care team to conduct your wellness visit. A nurse might provide your care instead of your doctor during a time that is convenient for you.

In previous check-ups, you may have had your primary care provider conduct a head-to-toe physical exam and give you the opportunity to address other concerns with your health. These are not included within Medicare’s Annual Wellness Visit, but can be conducted with a regular office visit on the same day as your Annual Wellness Visit appointment.

Why is a Medicare Annual Wellness Visit important?

“The Medicare Annual Wellness Visit is a unique visit that holds tremendous value for patients,” Goel said. “It approaches health from multiple vantage points that are particularly important for seniors. It detects issues sooner than we can during a traditional office visit – such as problems with memory, nutrition or safety.”

If you are on Medicare, each year, contact your primary care provider to schedule an Annual Wellness Visit with your health care team.

17 responses to “Medicare Annual Wellness Visit vs annual check-up: What’s the difference?”

  1. Paul D Jones

    Does Medicare cover yearly eye exams ?

    1. Jacob Zipperer

      Hello Paul,

      For more on Medicare and eye exam coverage, you may find this webpage helpful: https://www.medicare.gov/coverage/eye-exams-routine

      Thank you,
      Jake

  2. GREGORY SCOHIER

    2055 cactus lane

    1. GREGORY SCOHIER

      Hi Guys, I just recently had my yearly check up at my primary care doctor's office. I've received about a $900 bill from Quest Diagnostics for this, that and the other thing..They said Medicare doesn't cover this. Really ??

  3. Hairstyles

    I mastered more a new challenge on this weight reduction issue. 1 issue is a good nutrition is extremely vital whenever dieting. A massive reduction in fast foods, sugary food, fried foods, sweet foods, beef, and whitened flour products can be necessary. Possessing wastes harmful bacteria, and toxic compounds may prevent goals for fat loss. While specified drugs temporarily solve the situation, the horrible side effects will not be worth it, plus they never supply more than a short-lived solution. It is just a known idea that 95 of celebrity diets fail. Many thanks for sharing your notions on this blog site.

  4. candace levine

    This is not a medical exam! It is a way for the physicians office to make monies off Medicare and do virtually nothing for it. I have always had my annual wellness check up but I will no longer particapate in this sham. Good going Medicare. You are about as much good a a wart.

  5. Nancy kiefer

    Do you mean Medicare A provides this or are you referring to one of the medicare insurance plans. I am only on A as I am still working and have insurance.

    1. Kirsten Shakal, Shine365 Editor

      Hi, Nancy. Typically Medicare Part A covers inpatient services. Medicare Part B covers clinic/outpatient services. The Medicare Annual Wellness Visit is a clinic based service. In other words, it would not be covered under your Medicare A plan.

      This site may be helpful for you: https://www.medicare.gov/what-medicare-covers/what-part-a-covers

      Thank you for reading Shine365. -Kirstie

  6. Patti Rasmussen

    I'm new to Medicare this year and find this rather confusing as well. How should we decide whether to schedule a Wellness Visit and/or a regular physical exam? I have a Medicare Advantage Plan through Security Health. Do I need to contact them to see what would be covered if I have both the Wellness Visit and an regular exam?

    1. Kirsten Shakal, Shine365 Editor

      Hi, Patti.

      Your insurance provider, Security Health Plan, or your primary care provider are great resources for questions about your regular annual check-up versus a Medicare Annual Wellness Visit.

      -Kirstie

  7. Marilyn Skatrud

    Seems like I have had my annual – right?

    1. Kirsten Shakal, Shine365 Editor

      Hi, Marilyn. Our writing team doesn't have access to patient information and want to be sure we protect your patient privacy at all times.

      If you have questions or concerns about your previous visits, please contact your care team directly or use My Marshfield Clinic: https://marshfieldclinic.org/mymarshfieldclinic They have that information and are happy to help you.

      -Kirstie

  8. Gary Schwartz

    I have an appointment w/Dr. Gill on […]. I would like it to be a wellness visit. He can think about this and let me know what he thinks, by that I mean, he knows my past health requirements and what his thoughts are for my future health.

    1. Kirsten Shakal, Shine365 Editor

      Hi, Gary. We want to protect your patient privacy. That said, if you have any questions about your appointment with Dr. Gill, please contact him directly or use My Marshfield Clinic: https://marshfieldclinic.org/mymarshfieldclinic

      Thank you for reading Shine365. -Kirstie

  9. Carol Rand

    So what you are telling me is I need to schedule a Wellness check and my yearly physical exam separate. Is this correct?

    1. Kirsten Shakal, Shine365 Editor

      Hi, Carol. Dr. Goel said this in response to your question:

      If you are on medicare:
      Schedule an annual wellness check once a year. This can be scheduled on the same day as your regular check-up already planned with your primary care provider. If those check ups were once a year then, yes, it would be separate from your normal yearly check.

      If you are not on medicare:
      Schedule annual yearly exams just as you always did. Schedule follow-up visits just as you always did.

      I hope that helps. If you have specific questions about your care history or care plan, please reach out to your primary care provider. -Kirstie

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