What Is a Yearly Wellness Visit?

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The Yearly Wellness Visit, also known as the Annual Wellness Visit, is a yearly appointment that Medicare covers for its beneficiaries. A Yearly Wellness Visit is created to help Medicare beneficiaries maintain good health by detecting signs of disease early on and taking a precautionary approach to their healthcare. The visit was introduced by CMS to address the health risks that older populations face and encourage them to take control of their health and life.

What to Expect During a Yearly Wellness Visit

You’ll see a doctor or nurse for your annual wellness visit. You can expect them to discuss some things with you, including your health history, prescription drugs, and vaccination schedule. Some of the other components of yearly wellness visits are a wellness schedule, Health Risk Assessment (HRA), personal health records, and advance directives. To simplify it, Yearly Wellness Visits are typically composed of 3 main parts, including:

Senior man at a yearly wellness visit and learning what to expect.
You can expect them to discuss some things with you, including your health history, prescription drugs, and vaccination schedule.

High-Risk Assessment (HRA): This is a screening tool and questionnaire that assesses your health status and gives feedback about your actions that can be used to limit risks and promote overall well-being. Before the assessment can be calculated, you’re required to self-report details on these subjects:

  • Demographics
  • Behavioral Risks
  • Psychosocial Risks
  • Self-Assessment of Health Status
  • Medical and Family Health History
  • Instrumental Activities of Daily Living (ADLs)

The questionnaire may also include questions about advanced healthcare planning. Based on your answer, the healthcare provider will be able to determine the risk factors and create a plan that helps prevent this.

Vitals: This includes collecting and recording vitals. These routine measurements include your weight, blood pressure, and height, which are important to examine when discussing risk factors related to stroke, cardiovascular, and hypertension. Weight and height are used to estimate and report on BMI.

Health Consultation: During the consultation portion, you and your provider will take the Health Risk Assessment results and develop a 5-10-year care plan. Depending on your answers in the questionnaire, your health provider will ascertain risk factors and discuss a preventative healthcare plan geared towards better health.

Yearly Wellness Visit vs. Annual Physical Exam

Unfortunately, federal law prohibits Medicare from covering annual physicals. Annual physical exams measure all vital signs, thoroughly examine you, and submit orders such as blood tests and urine samples. However, the Annual Wellness Visit doesn’t offer such a thorough examination; instead, it focuses on reviewing your medical history and creating a prevention plan.

Another important difference between Yearly Wellness visits and Annual Physical Exams is that the AWV doesn’t require coinsurance because Medicare provides full coverage for this service and reimburses providers for it. On the other hand, Medicare doesn’t reimburse healthcare providers for Annual Physical Exams.

Need More Information? We Can Help!

By performing Yearly Wellness Visits, you and your healthcare provider can create a plan that helps prevent future health issues. For more information about Yearly Wellness Visits and how Medicare will cover them, contact Bobby Brock Insurance today.

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Justin Brock

President & CEO of Bobby Brock Insurance