The Three Words for Cognitive Screening During a Wellness Exam
The most commonly cited three words used for a Medicare wellness exam memory test are "banana, sunrise, chair". It is important to note that a healthcare provider may use a different set of words. This simple recall test is part of the Mini-Cog screening, one of several tools used to assess cognitive function during the Medicare Annual Wellness Visit (AWV). The provider asks the patient to repeat the words, then engages in conversation before asking them to recall the words again a few minutes later. The purpose of this test is to help identify early signs of memory issues that warrant further evaluation.
Beyond the Three Words: The Full Scope of the Wellness Exam
The cognitive screening is just one component of the comprehensive AWV, a benefit for all Medicare Part B beneficiaries after their first 12 months of coverage. Unlike a traditional physical exam, the AWV is focused on preventive care and creating a personalized health plan.
What the AWV Includes:
- Health Risk Assessment (HRA): A questionnaire covering demographics, health status, behavioral risks, and daily living activities.
- Medical and Family History Review: A detailed discussion to identify hereditary risks and update your health record.
- Physical Measurements: Includes checking your height, weight, and blood pressure.
- Functional Ability and Safety Assessment: Screening for risks of falling and evaluating your ability to perform daily activities.
- Review of Current Medications: An evaluation of your prescriptions, over-the-counter medications, and supplements.
- Depression Screening: Assessment for any risk factors or current symptoms of depression.
- Personalized Prevention Plan: A five-to-ten-year screening schedule and health advice based on your risk factors.
- Advance Care Planning: An optional discussion about your future medical care wishes.
Comparing the Medicare Wellness Exam and a Traditional Physical Exam
Many patients confuse the Medicare AWV with a standard physical exam, but they are quite different. The main distinction lies in their purpose, coverage, and the specific procedures involved.
| Feature | Medicare Annual Wellness Visit (AWV) | Traditional Physical Exam |
|---|---|---|
| Purpose | Preventive care and health planning | Comprehensive hands-on assessment and diagnosis |
| Focus | Assessing health risks and creating a prevention plan | Diagnosing and treating new or existing medical problems |
| Physical Examination | Limited; includes vital signs and measurements | Detailed, hands-on exam (listening to heart/lungs, etc.) |
| Cost | 100% covered by Medicare Part B (after 12 months) | Not covered by Medicare; may incur co-pays/deductibles |
| Problem Management | No discussion or treatment for new or chronic illnesses | Addresses new symptoms and manages chronic conditions |
| Included Items | Health Risk Assessment, cognitive screening, personalized plan | Blood work, lab tests, hands-on physical assessments |
Preparing for Your Medicare Wellness Exam
To make the most of your appointment, it's wise to come prepared. Gathering key information beforehand ensures your provider can create the most effective personalized prevention plan.
- Update your medical history: Have a list of any new diagnoses, surgeries, or hospitalizations since your last visit.
- Compile a complete medication list: Include all prescription drugs, over-the-counter medications, vitamins, and supplements you are taking, along with dosages.
- List all your healthcare providers: Write down the names and contact information for any specialists you see.
- Know your family health history: Gather information on hereditary diseases or conditions that run in your family.
- Document key dates: Keep a record of recent screenings like mammograms, colonoscopies, and other preventive services.
- Consider a companion: If you have concerns about memory or cognitive function, consider bringing a family member or caregiver who can offer additional perspective to the doctor.
The Importance of the Cognitive Assessment and Early Detection
While the "three words" task may seem simple, it's a valuable part of the cognitive screening process. Detecting cognitive impairment early is crucial for several reasons. It provides an opportunity to identify potentially reversible causes, like vitamin deficiencies or medication side effects. Early detection also allows for the development of care plans to manage symptoms, improve quality of life, and give patients a voice in their care decisions. If a potential issue is identified during the AWV screening, Medicare covers a separate, more in-depth cognitive assessment to establish a diagnosis and create a focused care plan.
Conclusion
For the Medicare wellness exam in 2025, the phrase "banana, sunrise, chair" serves as a practical example of the brief cognitive test you might encounter. However, the true three words to remember are prevention, planning, and awareness. The entire visit is designed to be a proactive conversation with your doctor, identifying potential health risks and creating a personalized strategy to help you stay well. By focusing on prevention, engaging in thoughtful planning, and remaining aware of your health, you empower both yourself and your healthcare team to navigate your health journey more effectively. This ensures the annual wellness visit is a powerful tool for maintaining your health for years to come.
Understanding the Purpose of a Medicare Annual Wellness Visit (AWV)
