Medicare Annual Wellness Visit

Coverage rules with Medicare can throw people. A good example is the verbiage “Annual Wellness Visit” as opposed to Annual Physical. Federal law prohibits the health care program from paying for annual physicals, and patients who get them may be on the hook for the entire amount. But beneficiaries pay nothing for an “annual wellness visit,” which the program covers in full as a preventive service. 
What’s the difference? An annual physical typically involves an exam by a doctor along with blood work or other tests. The Medicare annual wellness visit generally doesn’t include a physical exam, except to check routine measurements such as height, weight and blood pressure. The focus of the Medicare wellness visit is on preventing disease and disability by coming up with a “personalized prevention plan” for future medical issues based on the beneficiary’s health and risk factors. Medicare beneficiaries pay nothing for the annual wellness visit as long as their doctor accepts Medicare. However, if a wellness visit, goes beyond the bounds of the specific covered preventive services into diagnosis or treatment — whether at the urging of the doctor or the patient — Medicare beneficiaries will typically owe a copay or other charges. 
The main take away is when making an appointment be sure to say Annual Wellness Visit not Annual Physical.