Medicare’s Annual Wellness Visit (AWV) is a preventive service designed to help Medicare beneficiaries maintain health and prevent disease — distinct from a traditional physical examination and covered with no cost-sharing for patients who have been enrolled in Medicare Part B for more than 12 months. Understanding what the AWV includes and how to maximize its value helps Medicare beneficiaries engage fully with this important preventive service. This guide explains what Medicare covers for preventive care at your clinic.
What the Annual Wellness Visit Includes
- Review of medical and family history
- Blood pressure, height, weight, body mass index measurement
- Cognitive impairment screening (asking orientation questions, memory assessment)
- Depression screening
- Functional ability assessment (activities of daily living)
- Fall risk assessment and fall prevention counseling
- Safety assessment (home safety, seatbelt use, smoke detector)
- Review and update of current preventive services (what screenings are due)
- Review and update of current medications
- Personalized health advice and referrals for preventive services
- Development or update of a Personalized Prevention Plan
- Advance care planning discussion (optional, separately billed)
What the AWV Is Not
The AWV is not a traditional physical examination — it does not include a head-to-toe physical exam, and any acute problems identified during the AWV typically require a separate, separately billed sick visit. Many Medicare patients are surprised to receive a bill when their provider addresses a medical problem during the AWV — understand that the AWV is specifically a preventive visit, and clinical problems warrant a separate claim.
Additional Medicare Preventive Services
Beyond the AWV, Medicare covers: annual mammograms, Pap smears every 24 months (annually for high-risk), colorectal cancer screening (colonoscopy or stool tests), abdominal aortic aneurysm screening (one-time, for smokers), bone density (DEXA) every 24 months for high-risk, lipid panel, diabetes screening (if risk factors present), and influenza, pneumococcal, hepatitis B, and COVID-19 vaccinations.
Conclusion
The Medicare Annual Wellness Visit is a valuable, fully covered preventive service that gives your care team a comprehensive view of your preventive needs and health status. Schedule yours annually, come prepared to discuss your health history and any concerns, and use the personalized prevention plan it generates to guide your healthcare priorities for the coming year.
FAQs – Medicare Annual Wellness Visit
Q1. What is the difference between the AWV and a “Welcome to Medicare” visit?
A: The “Welcome to Medicare” preventive visit is a one-time visit in the first 12 months of Medicare Part B enrollment — a comprehensive initial health assessment. The Annual Wellness Visit is conducted annually after the first 12 months and updates the personalized prevention plan developed at the Welcome visit. Both are covered with no cost-sharing.
Q2. Why did I get a bill after my “free” wellness visit?
A: If your provider addressed a medical problem (even briefly) during the AWV, that portion of the visit was billed as a separate sick visit with normal cost-sharing. To avoid unexpected bills, inform your provider before the AWV that you want it strictly focused on the preventive wellness visit, and schedule a separate appointment for medical problems.
Q3. Does Medicare cover depression treatment?
A: Medicare Part B covers outpatient mental health services including individual and group therapy with a 20% coinsurance after the deductible. Medicare Advantage plans often have additional mental health coverage. Antidepressant medications are covered under Medicare Part D prescription drug plans.
Q4. How often does Medicare cover colonoscopy?
A: Medicare covers a screening colonoscopy every 10 years for average-risk beneficiaries. High-risk patients (prior colon polyps or cancer, family history) may be covered every 2–5 years. The initial colon cancer screening is covered with no cost-sharing; coinsurance applies if polyps are removed during the screening (converting it to a therapeutic procedure at many plans).
Q5. Does Medicare cover hearing aids and dental care?
A: Traditional Medicare (Parts A and B) does not cover hearing aids, routine dental care, or vision (glasses/contacts). Medicare Advantage (Part C) plans often include supplemental dental, vision, and hearing benefits — coverage varies widely by plan. Medically necessary dental procedures related to a covered medical condition may have limited Medicare coverage.
