Published: Aug. 4, 2011
Updated: Aug. 4, 2011
In 2011, Medicare began paying for an annual wellness visit (AWV) with your primary care provider, and there are no co-pays or deductibles for this visit.
The annual wellness visit is a strategy session designed to help you and your primary care provider develop an ongoing health plan intended to keep you healthy, safe, and independent for a long time.
The purpose of your annual wellness visit is to review your medical history, identify any potential health risks, and develop a personalized preventive services plan that will include appropriate health screenings.
If after your visit your health care provider determines additional evaluation is necessary, there may be a fee associated with some services.
Your annual wellness visit includes:
No. The annual wellness visit is not a physical. An annual physical is a more extensive physical examination. In addition to collecting a medical history, a physical may also include:
You may choose to have a physical at another visit, but Medicare will not pay for this service.
If you have a Medicare Advantage or other type of Medicare replacement plan, you will need to see if the plan pays for an annual physical; otherwise, you will be responsible for payment.
You pay nothing out of pocket for this visit. However, you may be responsible for a deductible or co-pay expense if additional evaluation is required.
You are eligible for the annual wellness visit after you have had Medicare Part B for more than 12 months. However, if you've had a “Welcome to Medicare” visit within the last 12 months, you must wait 12 months from that visit before you can have your annual wellness visit.
It will depend on the severity of the illness and your health care provider's schedule, but it may be possible. Medicare will pay for the sick visit, but it is subject to the deductible and co-pay.
You may have an annual wellness visit once every 12 months.
You will see your primary care provider, who could be a physician, nurse practitioner, or physician assistant.
Depending on which Duke Medicine clinic you go to, you may also spend time with nursing staff or other medical professionals who will help gather your medical history so that your health care provider can determine an appropriate preventive health screening plan.
Medicare covers many screenings for people who are at high risk for certain diseases. During your annual wellness visit, you and your health care provider will decide on which evaluations, tests, and screenings are appropriate for you. Some evaluations, tests, and screenings may be subject to the deductible or co-pay.
To determine when you become eligible for your first Medicare annual wellness visit, call your primary care provider’s office.
Call 888-ASK-DUKE (888-275-3853) to for assistance with finding a Duke Medicine primary care provider.