Annual Wellness Visit for Medicare Advantage Plan Members

Your Medicare Advantage Plan provides coverage for an Annual Wellness Visit (AWV), also called an Annual Health Assessment (AHA). The AWV or AHA is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan. It can also help prevent illness based on your current health and risk factors.

Be Your Own Advocate

The AWV helps create a complete picture of your health and what to do to be healthier. The more you know about your health, the more you can do about it. So, schedule your Annual Wellness Visit, and talk to your doctor about how to live better!

The AWV is not a head-to-toe physical. Instead, it is similar to the one-time Welcome to Medicare Visit you received when you join Medicare. The AWV lets you and your doctor talk about your health history and any other health concerns. You can also review your medications and immunizations. You and your doctor can also check on your existing health problems and determine any potential future concerns, and how to prevent them.

The goal of an Annual Wellness Visit is to create a complete personal and family health history and help prevent future health problems.

What to Bring to Your Annual Wellness Visit

  • A list of all medications, including vitamins and supplements
  • Names of all your healthcare providers. This includes doctors, pharmacists, therapists, home health agencies, and non-traditional providers
  • Your immunization records, including flu or pneumonia shots
Covered Services

During your first Annual Wellness Visit, your PCP will develop a prevention plan just for you. Your PCP and care team may also:

  • Check your height, weight, blood pressure, and other routine measurements
  • Ask you to complete a health risk assessment questionnaire. You may be asked to do this before or during the visit. You will be asked about your current health, injury and behavioral risks, and any urgent needs.
  • Review your functional ability and level of safety, including screening for hearing impairments and fall risk.
  • Assess your ability to perform daily tasks (such as bathing and dressing), and your level of safety at home.
  • Learn about your medical and family history
  • Make a list of your current providers, durable medical equipment (DME) suppliers, and medications
  • Review prescriptions, as well as any vitamins and supplements
  • Create a written 5-10 year screening schedule based on your health status and screening history and offer age-appropriate, Medicare-covered preventive screening services
  • Check for cognitive issues, such as Alzheimer’s and other forms of dementia and depression
  • Provide health advice and referrals to education and preventive counseling services to find risk factors and promote wellness
At subsequent AWVs, your doctor should:

  • Check your weight and blood pressure
  • Update your health risk assessment
  • Update your medical and family history
  • Update your list of current medical providers and suppliers
  • Update your written screening schedule
  • Screen for cognitive issues
  • Provide health advice and referrals to health education and/or preventive counseling services
Costs

Medicare Advantage Plans must cover AWVs without applying deductible, copayments or co-insurance. This applies as long as your provider is in-network and you meet eligibility requirements.

If your provider finds a need to treat a new or existing problem during your visit, then this is considered diagnostic. This is since you are being treated for certain symptoms or risks. You may then need to pay for your portion of co-payment or coinsurance.

For more information from Medicare, click here. https://www.medicare.gov/coverage/yearly-wellness-visits

Call your primary doctor today and schedule yours. Be Your Own Advocate!