Medicare Annual Wellness Visit vs. an Annual Physical

Medicare will cover an annual wellness visit, but not an annual physical.  “Well,” you might ask “what’s the difference?”  During a Medicare annual wellness visit, the provider will measure height, weight, body mass index (BMI), and blood pressure.  The provider will also go over your medical history, family medical history, and any potential risk factors for preventable diseases such as Type II diabetes and depression.

An annual physical is a more extensive exam than a Medicare Annual Wellness Visit. In addition to these services, a typical annual physical might also include services such as a vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, and a check of your reflexes.  Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit.

The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care. At the first wellness visit, patient will often fill out a risk-assessment questionnaire and review their family and personal medical history with their provider, nurse practitioner or physical assistant. The clinician will may create a schedule for the next mammogram, colonoscopy, prostate screening, bone density measurements, evaluate for cognitive problems, flu shots, depression, fall risk and other safety issues. Any additional tests or labs that may be required as a result of the findings of your annual wellness visit would be billed separately by your provider and would fall under a different benefit than your annual wellness visit.