Are Annual Wellness Visits and Physicals the Same?

When it comes to preventive care, many medicare beneficiaries are surprised to learn that an Annual Wellness Visit (AWV) is not the same as a traditional physical exam. Understanding the difference can help you take full advantage of your Medicare benefits - and avoid unexpected costs.

What is an Annual Wellness Visit (AWV)?

The Annual Wellness Visit is a once-a-year appointment covered by Medicare Part B, focused on prevention and long-term health planning. It's not a full physical exam, it's more of a conversation and review of your overall health.

What's Included in an AWV?

• Review of medical and family history
• Height, weight, blood pressure, and other basic measurements
• Cognitive impairment screening
• Depression and mood assessment
• Health risk assessment questionaire
• Personalized screening schedule (e.g. mammograms, colonoscopies)
• Advanced care planning (optional)

What is a Physical Exam?

A physical exam is a comprehensive, hands on medical checkup. It usually includes:

• Listening to your heart and lungs
• Examining your ears, nose, and throat
• Palpitating the abdomen
• Checking reflexes and skin
• Often includes blood work or diagnostic tests

Medicare does not cover routine physicals, except for the "Welcome to Medicare" visit (available within the first 12 months of enrolling in Part B).

Who is Eligible for an Annual Wellness Visit?

You qualify for an Annual Wellness Visit if you have had Medicare Part B for at least 12 months. You can also qualify for an AWV if you have not had one (or a Welcome to Medicare) visit within the past 12 months.

Do Medicare Advantage Plans Cover Annual Wellness Visits?

Yes, Medicare Advantage (Part C) plans are required to cover the same preventive services as Original Medicare, including AWVs. Many Advantage plans may offer additional preventive services or wellness incentives as part of their benefits.  Always confirm with your Advantage plan which providers are in-network and whether any additional screenings performed during the visit may incur a cost.

What to Bring to Your Annual Wellness Visit

To make the most of your AWV, bring:

• A list of your current medications (including over-the-counter drugs and supplements)
• Names of your healthcare providers and specialists
• Your family medical history
• Immunization records
• Any recent test results or hospital discharge summaries
• A list of questions or health concerns

If you're interested in discussing advance directives (like a living will or power of attorney), bring those documents or let your provider know that you'd like to create one.

Watch Out for Extra Charges

The AWV is free, but if your provider orders lab tests or screenings that are not part of the visit, or if your provider treats a new or existing condition during the visit, you may be charged for those services. These are considered diagnostic, not preventive.

Final Thoughts

While it may not replace the hands-on reassurance of a physical, the Annual Wellness Visit is a valuable tool for keeping your health on track, and it's 100% covered by Medicare. Make sure to take advantage of it every year, and speak with your provider if you'd like additional screening or a more thorough physical exam.

Our licensed agents are here to guide you through Medicare coverage, Advantage plan options, and how to make the most of your benefits. Give us a call - we are happy to help!

To Get Help Now, Call Our Office!

​Rob and Carrie Davies
Prairie Grove Insurance
800-254-5200
​608-839-0275