Medicare Wellness Visit

The Medicare Wellness visit is one of the many benefits the Affordable Care Act (ACA) brought to seniors. Despite being launched in January of 2011, however, many primary care physicians and their patients are still not utilizing the benefit. For physicians, the visit provides them with an opportunity to develop a preventative plan for each patient on an individual basis. There is financial incentive for physicians to be sure their Medicare patients schedule the wellness visit – it pays nearly three times the rate of a typical Medicare patient visit.

So why are many seniors still not taking advantage of the benefit? Most are simply unaware of it and what it entails.

The Medicare Wellness Visit

The once-a-year benefit is a wellness visit provided at no cost to seniors. The focus of it is to develop or update prevention plans and evaluate chronic health conditions, such as diabetes or asthma. The physician will talk with the patient about their health, lifestyle and overall fitness regime. In addition, the physician will likely:

  • Measure height, weight, and body mass index
  • Check blood pressure
  • Perform a simple vision test
  • Evaluate cognitive function
  • Assess the patient for their risk of depression
  • Other routine testing based on patient and family medical history
  • Refer patient for further testing or evaluation by specialists if necessary

Based on their discussion with the patient and the results of the physical examination, the primary care physician will develop a personalized preventative care plan that includes timelines for health screenings. They will also make recommendations for any lifestyle improvements they believe will contribute to the patient’s overall health and wellness. It might be nutrition counseling, a smoking cessation program or suggested physical activities.

Medicare Welcome Visit versus Wellness Visit

There is some confusion among patients because Medicare also allows a one-time Medicare Welcome Visit. This appointment is for new Medicare recipients. It must take place within the first year of receiving Medicare Part B benefits.

Medicare Part B Wellness Visit Costs

Because one of the goals of the Affordable Care Act is to reduce health care expenses by focusing more on prevention, there is no cost to Medicare Part B recipients. Patients are entitled to one wellness visit every 11 months. One important thing to note is that while the visit is at no cost to patients, any recommendation testing or follow-up may not be.

If you are the caregiver for an older adult in Michigan, be sure to speak with their physician about scheduling an appointment to take advantage of this benefit.

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