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Helping Your Patients Understand Medicare’s Annual Wellness Visit


Very few patients are taking advantage of the Annual Wellness Visit (AWV) offered as a preventive service expanding those already in place through Medicare.  Since the start of this year, the Affordable Care Act has allowed for AWV coverage, waiving copayment and deductibles, creating easy access for patients. 

Why are patients not scheduling their Annual Wellness Visits?

Some doctors assume patients don’t feel the need for an AWV if they are already experiencing these medical procedures in their scheduled visits, while others feel patients are perhaps not interested in the preventive service.  

However, research demonstrates that one of the largest issues is that health care providers may not be aware that big chances have been made and that they can now offer these services to Medicare patients for free.


Quick Guide

1. The Initial Preventive Physical Exam (IPPE)

This exam is also known as the “Welcome to Medicare” visit.

The exam must take place in the first 12 months of Part B eligibility.  The visit consists of a physical examination, checking general vitals, as well as anything else the healthcare provider deems necessary.  Patients should bring their medical history information to the visit including medication lists, allergies, past hospitalizations and family medical history.  The healthcare provider will also educate the patient on other Medicare Part B benefits, potential risk factors in mental health, physical ability and safety, as well as end-of-life planning if desired.


2. The First Annual Wellness Visit (AWV)

This exam must take place at least 12 months after the patient’s IPPE.  Just as in the Welcome to Medicare visit, the healthcare provider will ask the patient questions on their medical and surgical history.  General procedures of height, weight and blood pressure will take place as well as anything else warranted by the patient’s medical history. The patient will be educated on providers in the area able to provide patients with treatment and may also give personalized advice and referrals as needed.  Risk factors of depression, physical safety and potential conditions will be discussed.  Healthcare providers should also write a schedule of suggested screening tests that should be performed over the next 5-10 years.


3. Subsequent Annual Wellness Visits (AWVs)

Appointments for subsequent AWVs should be scheduled every year, 12 months later than the last AWV.

This visit consists of general updating as well as yearly screening.  Medical history will be updated and providing a list of these changes will be helpful for both patient and doctor.  Height, weight and blood pressure will be measured and charts will be updated.  Thought process will be screened and the written screening schedule from the first WVA will be updated.  Personalized health referrals to education or counseling offices will be given as necessary.


Important Patient Clarifications:

Copay, coinsurance, or deductibles are only waived if the visit is strictly over preventive services.  

Visits that combine preventive procedure with other medical treatment such as routine blood work are not covered by AWV benefits.  Patients should be sure to make separate appointments for AWV and general medical treatment or prescription refills.


Source: Medscape

[image by Seattle Municipal Archives]


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