How often can Medicare Wellness be done?

Oct 24, 2025 4 min read •

Health Medicare Insurance

According to the Centers for Medicare & Medicaid Services (CMS), beneficiaries can receive a Medicare wellness visit once every 12 months, and often at no cost. Understanding how often can Medicare wellness be done is key to proactively managing your health and taking full advantage of your benefits.

Quick Summary

The Medicare Annual Wellness Visit is covered once every 12 months for eligible beneficiaries. A separate, one-time "Welcome to Medicare" visit is available within the first 12 months of Part B coverage. These visits focus on preventive care and creating a personalized health plan, not on treating existing illnesses.

Key Points

Annual Wellness Visits (AWV) are covered once every 12 months. You must wait a full 11 months after your last visit to schedule your next one.
The "Welcome to Medicare" visit is a one-time benefit. New Part B enrollees are eligible for this within their first 12 months of coverage.
Wellness visits focus on prevention, not treatment. They are not the same as a routine physical exam, which Medicare does not cover.
Wellness visits are a covered benefit with no out-of-pocket costs. Beneficiaries pay nothing if their provider accepts Medicare assignment.
The visit includes a health risk assessment and personalized prevention plan. Your provider will use this information to identify risk factors and create a long-term health strategy.
You can have an AWV with a doctor, nurse practitioner, or physician assistant. It is often conducted by a nurse, focusing on interviews and assessments rather than a hands-on exam.

Your Annual Wellness Visit Explained

Medicare’s preventive health benefits, specifically the Annual Wellness Visit (AWV), are a crucial tool for beneficiaries to stay on top of their health. The Annual Wellness Visit can be done once every 12 months, meaning a full 11 months must have passed since your last AWV. It is a proactive, no-cost check-in focused on prevention rather than diagnosing existing problems. This visit provides an opportunity to develop or update a personalized prevention plan to help you avoid illness and injury.

What happens during your annual visit?

During a Medicare Annual Wellness Visit, you will typically fill out a health risk assessment questionnaire and meet with a healthcare provider. The assessment collects information about your health status, daily activities, and potential risk factors. Your provider will also perform several routine measurements and screenings.

Key components of the visit include:

Health Risk Assessment: A questionnaire covering your health status and risk factors.
Review of Medical and Family History: Updating your and your family's medical history to understand potential hereditary conditions.
List of Current Providers: A list of all healthcare providers and suppliers involved in your care.
Routine Measurements: Recording your height, weight, body mass index (BMI), and blood pressure.
Cognitive Assessment: A screening to detect potential cognitive impairment, such as signs of dementia.
Personalized Prevention Plan: The creation of a written screening schedule and personalized health advice for the next 5-10 years.
Advance Care Planning: Optional discussion and information regarding advance directives, like a living will.

It is important to prepare for your appointment by completing any necessary paperwork in advance and bringing a list of all your medications, vitamins, and supplements. This preparation ensures you get the most out of your visit and that your healthcare provider has the most accurate information to create your prevention plan.

The "Welcome to Medicare" visit

For new Medicare beneficiaries, there is a one-time Initial Preventive Physical Examination (IPPE), also known as the “Welcome to Medicare” visit. This can be done within the first 12 months of being enrolled in Medicare Part B. After you have completed this visit, you are eligible for your first Annual Wellness Visit 12 months later. This visit serves a similar purpose to the AWV but is specifically for new enrollees and can include a one-time electrocardiogram screening.

Understanding the 12-month rule

The 12-month rule for the Annual Wellness Visit is not based on a calendar year but on the date of your last visit. If you had your visit on September 15, 2025, you cannot schedule your next one until September 16, 2026. This is a common point of confusion for many Medicare beneficiaries and their providers, but it is a strict guideline enforced by Medicare. This distinction is critical for both the patient, to ensure they can plan accordingly, and for the provider, to ensure proper billing.

Comparison: Medicare Wellness Visit vs. Routine Physical

Many people confuse the Medicare Annual Wellness Visit with a standard physical examination, but they are distinctly different in purpose and coverage. The AWV is focused on prevention and proactive planning, while a routine physical is for a head-to-toe examination to diagnose and treat existing medical issues.


Feature	Medicare Annual Wellness Visit (AWV)	Routine Physical Examination
Purpose	To create or update a personalized prevention plan.	To diagnose and treat existing medical conditions.
Cost	100% covered by Medicare Part B, with no copayment or deductible (if provider accepts assignment).	Not typically covered by Medicare; patients pay 100% out-of-pocket.
Frequency	Once every 12 months.	Can be scheduled anytime, but is not covered by Medicare.
Includes	Health risk assessment, review of history, cognitive screening, measurements, prevention plan.	Comprehensive physical exam, head-to-toe checkup, and potential lab tests.
Excludes	Lab tests, full physical exam, and treatment for current issues.	Proactive prevention planning.

It is possible to have a wellness visit and a routine physical on the same day. However, any services related to the physical or treatment of existing conditions will likely incur costs. It is best to clarify with your provider beforehand to avoid any surprise bills.

Conclusion

Ultimately, a Medicare Annual Wellness Visit is an invaluable tool for proactive health management, providing beneficiaries with a structured and preventative approach to their long-term well-being. By taking advantage of this free, yearly benefit, you can work with your healthcare provider to create a personalized prevention plan tailored to your specific needs and risk factors. Remembering the 12-month interval is crucial for planning your appointments and ensuring full Medicare coverage. Unlike a traditional physical, which is not typically covered, the AWV is a no-cost opportunity to address health risks before they become serious issues, helping you stay healthier in the long run.

For more official details on the Medicare Wellness Visit, you can refer to the official Medicare website.

Frequently Asked Questions

A Medicare wellness visit focuses on preventive care and creating a personalized prevention plan, while a routine physical exam is for diagnosing and treating existing illnesses and is not covered by Medicare.

No, Medicare covers the Annual Wellness Visit at 100% with no copayment or deductible, as long as your provider accepts Medicare assignment.

If your provider performs additional tests or services to treat an existing condition, you may have out-of-pocket costs such as a copayment or coinsurance. Always clarify what is covered beforehand.

The "Welcome to Medicare" visit is a one-time preventive visit for new Medicare Part B enrollees that can be done within the first 12 months of coverage. After this visit, you become eligible for annual wellness visits.

Yes, you can, but any services or tests related to the physical exam for treating specific issues will likely have a separate charge. It is best to inform your provider that you want both services to avoid confusion.

You should bring a completed Health Risk Assessment (if provided in advance), a list of all your current medications and supplements, and any questions you have for your healthcare provider.

Yes, for traditional Medicare, you must wait 12 months between visits. However, some Medicare Advantage plans may allow for a visit at any time within the calendar year.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.