What to expect at a Medicare wellness check? Your guide to a yearly health plan

Oct 6, 2025 3 min read •

senior care Medicare Preventive Health

Research shows that Medicare patients who receive an Annual Wellness Visit are more likely to get recommended preventive services. Understanding what to expect at a Medicare wellness check can help you maximize this important annual benefit.

Quick Summary

A Medicare wellness check is a yearly preventive appointment focused on creating a personalized health plan based on a Health Risk Assessment, medical history review, and screenings, not a comprehensive physical exam for treating existing conditions. This proactive approach helps identify health risks and create a roadmap for future care.

Key Points

Preventive, not Diagnostic: The visit is for creating a personalized health plan to prevent disease, not for diagnosing or treating current medical issues.
Not a Physical Exam: a Medicare Wellness Check is a conversation and assessment, not a hands-on physical exam with blood work.
Preparation is Key: Gather your medical history, medication list, and a list of providers to have an efficient and productive visit.
100% Covered: The AWV itself is covered entirely by Medicare Part B, but additional tests or services are billed separately.
Creates a Roadmap: You will leave with a personalized prevention plan and a screening schedule for the next 5-10 years to guide your health decisions.
Annual Benefit: After the first year of Part B coverage, you are entitled to a Medicare Wellness Check once every 12 months.

What Is a Medicare Wellness Check?

A Medicare Annual Wellness Visit (AWV) is a yearly preventive health planning session covered by Medicare Part B. It focuses on creating or updating a personalized plan to prevent disease and disability based on your health and risk factors. It is not a physical exam for diagnosing or treating illnesses.

To be eligible, you need to have had Medicare Part B for over 12 months. Your first AWV is after the initial 12 months of Part B coverage, and subsequent visits are covered once every 12 months.

Before Your Visit: How to Prepare

Preparing for your AWV ensures a more productive appointment. You may receive a Health Risk Assessment (HRA) to complete beforehand. Bring the following information with you:

Your personal and family medical history.
A list of all your medications, vitamins, and supplements.
A list of your healthcare providers.
Results of recent screening tests or immunizations.
Questions or concerns you have about your health.

What to Expect During the Appointment

The visit is primarily a discussion with your healthcare provider, which could be a doctor, nurse practitioner, or physician assistant. The focus is on preventive care and planning, and may include:

Review of your Health Risk Assessment.
Measurement of vital signs like height, weight, BMI, and blood pressure.
Review and update of your medical and family history.
Brief screening for cognitive impairment.
Assessment of risk factors for depression.
Screening for functional ability, fall risk, and home safety.
Discussion of opioid use risks if applicable.
Creation or update of a personalized prevention plan with recommended screenings and services for the next 5-10 years.
Health advice on topics like nutrition and physical activity.
Referrals to health education or counseling.
Optional discussion of advance care planning.

Medicare Wellness Check vs. a Physical Exam

It's important to understand the difference between an AWV and a routine physical exam to avoid unexpected costs.


Feature	Medicare Annual Wellness Visit (AWV)	Routine Physical Exam
Purpose	Proactive health planning and prevention.	Comprehensive assessment, diagnosis, and treatment.
Services	Health history, risk factors, cognitive screening, personalized plan.	Hands-on physical examination, lab tests.
Focus	Staying healthy and reducing future risks.	Identifying and treating current health problems.
Coverage	100% covered by Medicare Part B (with provider assignment).	Generally not covered by Medicare.
Cost	No deductible or copayment for the AWV.	Typically out-of-pocket costs apply.

What Is Not Covered by the Wellness Check?

Certain services are not part of the AWV and may lead to additional charges:

Physical examinations: Hands-on exams are not included.
Lab tests and diagnostic screenings: These are billed separately.
Treatment for illnesses: Discussing and treating specific health problems will be billed as a separate visit.
Prescription management: Adjusting or prescribing medications for conditions is not included.

Make sure to state you are scheduling a “Medicare Annual Wellness Visit” when booking your appointment. If you have an urgent medical issue, schedule a separate sick visit.

Maximizing Your Medicare Benefit

After your AWV, you will receive a personalized prevention plan and screening schedule. To make the most of this visit:

Schedule recommended follow-up screenings or appointments.
Start any lifestyle changes discussed with your provider.
Keep your plan and health information for future reference.

This annual, no-cost visit is a valuable Medicare benefit. For official information, visit https://www.medicare.gov/coverage/yearly-wellness-visits.

Frequently Asked Questions

You can have a Medicare wellness check once every 12 months, after you have been enrolled in Medicare Part B for at least one year.

No, a Medicare wellness check is not a physical exam. It's a planning and assessment session, whereas a physical exam is a hands-on assessment for diagnosing conditions.

No, the Medicare Annual Wellness Visit is 100% covered by Medicare Part B if your provider accepts assignment. However, if other services or tests are performed, they may have a separate cost.

Bring your medical records, family history, a complete list of your medications and supplements, a list of your other providers, and any questions you have for your doctor.

The HRA is a questionnaire that helps you and your provider assess your current health status and risk factors. It covers your demographics, health self-assessment, behavioral risks, and daily living activities.

The wellness check is focused on prevention and risk assessment, not diagnosis and treatment. Therefore, medication adjustments or prescriptions are not typically part of this visit. They would be covered under a separate, potentially billed, office visit.

The 'Welcome to Medicare' visit (Initial Preventive Physical Exam) is a one-time benefit for new Medicare patients within the first 12 months. The Annual Wellness Visit is for after the first year and is repeated annually.

You can mention specific problems, but diagnosing or treating them is not part of the wellness visit. Your provider may address it during the same appointment, but it would be billed separately and could incur costs.

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.