What to Expect from the Health Risk Assessment (HRA)
The Health Risk Assessment (HRA) is a key part of your Medicare Annual Wellness Visit (AWV). It's a structured questionnaire designed to give your provider a comprehensive picture of your health. The HRA will cover various aspects of your life that can impact your well-being. By answering these questions, you and your doctor can work together to create or update a personalized prevention plan.
Medical and Family History Questions
Your provider will ask about your past and present health to identify risk factors and gaps in your care. Be prepared to discuss:
- Past and Current Medical Conditions: Your history of illnesses, hospitalizations, surgeries, and allergies.
- Current Medications: A complete list of your prescriptions, over-the-counter medications, and supplements, including vitamins and herbal products.
- Family Health History: Medical events in your family, especially hereditary conditions that may increase your risk for certain diseases.
Social History and Lifestyle Questions
Your lifestyle and social environment significantly impact your health. Questions in this section will likely address:
- Diet and Nutrition: Your eating habits and any nutritional concerns.
- Physical Activity: Your current exercise routine and activity level.
- Substance Use: Your history with alcohol, tobacco, and other illicit substances.
- Social Engagement: Your level of interaction with others, as social isolation can impact health.
Assessing Functional Ability and Safety
Your provider will assess your ability to perform daily tasks and your safety within your environment. This is crucial for maintaining independence and preventing injuries.
Daily Functioning and Fall Risk
- Activities of Daily Living (ADLs): Questions about your ability to perform basic tasks like bathing, dressing, and eating.
- Instrumental Activities of Daily Living (IADLs): Your ability to manage tasks like finances, housework, and transportation.
- Fall Risk: Questions about your balance, whether you use a cane or walker, and any recent falls.
Home Safety
Your provider may ask about potential hazards in your home that could lead to injury, such as throw rugs, poor lighting, or bathroom safety.
Screening for Mental and Cognitive Health
Mental and cognitive health are integral parts of your overall well-being. Your wellness visit includes screenings to help identify any potential issues early.
Depression Risk Assessment
Your provider will screen for depression and other mood disorders using a standardized tool. This may involve questions about your energy levels, sleep patterns, and feelings of hopelessness.
Cognitive Assessment
Your visit includes an assessment for signs of cognitive impairment, which can indicate conditions like dementia or Alzheimer's disease. The provider may directly observe you or ask you and others in your life questions about memory, concentration, and decision-making abilities.
The Personalized Prevention Plan
Based on your HRA answers and the other assessments, your doctor will create or update a personalized prevention plan. This plan is a proactive roadmap for your health and may include:
- Screening Schedule: A checklist of appropriate preventive services, such as immunizations and cancer screenings, based on your age, health status, and risk factors.
- Health Advice: Personalized advice on lifestyle changes related to diet, exercise, and safety.
- Referrals: Recommendations for wellness programs or specialists, if needed.
- Advance Care Planning: An optional discussion about your wishes for future medical treatment through an advance directive.
Initial vs. Annual Wellness Visit: A Comparison
There are two main types of wellness visits covered by Medicare Part B. Here's a quick look at the differences:
| Feature | Welcome to Medicare Visit (IPPE) | Annual Wellness Visit (AWV) |
|---|---|---|
| Eligibility | Once within the first 12 months of having Part B | Once every 12 months after the IPPE or previous AWV |
| Purpose | To introduce you to Medicare benefits, focus on prevention | To develop or update a personalized prevention plan |
| HRA | Included to collect initial health information | Included to track and update health risks |
| Scope | Includes a full review of health, social, and family history; also physical measurements | Updates existing health information; focuses on HRA and prevention plan |
Important: What the Wellness Visit is Not
It's important to understand what the wellness visit does not cover to avoid unexpected costs.
Distinguishing from a Routine Physical
A Medicare wellness visit is a strategic discussion about your long-term health and risk factors, not a physical exam. Your doctor will take routine measurements, but it's not the same as a head-to-toe physical that often addresses new or existing ailments.
No Clinical Lab Tests
The wellness visit does not include clinical lab tests. While your provider may recommend or order blood work or other tests based on the HRA, these are billed separately and may be subject to your deductible and copayments.
How to Prepare for Your Visit
To make your wellness visit as productive as possible, follow these steps:
- Gather Your Information: Bring a list of all your current medications and supplements, your immunization records, and any medical records from recent treatments or hospitalizations.
- Bring Your Family History: Have detailed information about your family's medical events, including any hereditary conditions.
- Create a List of Providers: Compile a list of all the doctors and specialists you see, including behavioral health specialists.
- Prepare Your Questions: Think about your health goals and concerns beforehand. This is your chance to ask about preventive screenings or lifestyle changes.
- Be Honest: Provide complete and accurate information on the HRA. Your honesty helps your provider give you the best advice and plan for your health.
Conclusion
By understanding what are the questions on the Medicare wellness test, you can better prepare for your appointment and actively participate in your health. The wellness visit is a powerful tool for proactive, preventive care, giving you and your doctor a clear roadmap for your long-term health. It's a yearly opportunity to focus on staying healthy, rather than just treating illness. For more detailed information, you can always refer to the official Centers for Medicare & Medicaid Services website. Taking an active role in this process is one of the best investments you can make in your well-being.
