A Medicare Health Risk Assessment (HRA) is a questionnaire you fill out as part of your Annual Wellness Visit. It collects information about your health habits, emotional well-being, and daily functioning so your provider can build a personalized prevention plan. Medicare covers it at no cost to you, with no deductible and no copay, as long as your provider accepts Medicare assignment.
What the HRA Covers
The HRA is not a blood test or a physical exam. It’s a structured set of questions designed to surface risk factors that your provider wouldn’t otherwise know about. CMS requires that it collect, at minimum, information in six categories:
- Demographic data: basic background information like your age and living situation
- Health status self-assessment: your own rating of how healthy you feel overall
- Psychosocial risks: depression, stress, anger, loneliness or social isolation, life satisfaction, pain, and fatigue
- Behavioral risks: tobacco use, physical activity, nutrition, oral health, alcohol consumption, sexual health, seat belt use, and home safety
- Activities of daily living (ADLs): your ability to dress, eat, use the toilet, groom yourself, bathe, and move around safely (including fall risk)
- Instrumental activities of daily living (IADLs): your ability to use the phone, prepare food, do housekeeping and laundry, manage transportation, shop, handle medications, and manage finances
The goal is to identify habits and limitations that could lead to serious health problems down the road. Smoking, poor nutrition, a sedentary lifestyle, or signs of depression are all things a standard lab panel won’t catch. The HRA is built to fill that gap.
How Your Provider Uses the Results
Your answers feed directly into a Personalized Prevention Plan. This is a document your provider creates during or after the visit that maps out which Medicare-covered preventive services you need and when. It lists screenings like mammograms, colonoscopies, or lung cancer scans based on your specific risk profile, along with recommended vaccinations and relevant lab work. The plan notes when each service was last completed, when it’s next due, and whether you declined anything. You receive a copy to take home.
Beyond the screening schedule, your provider uses the HRA to offer targeted counseling. If you report low physical activity, you might get a referral to a community exercise program. If you score high on depression or loneliness questions, your provider can connect you with behavioral health resources. The HRA turns a routine visit into something tailored to your actual life, not just your vital signs.
How It Differs From a Physical Exam
This is a common point of confusion. The Annual Wellness Visit, where the HRA takes place, is not a traditional head-to-toe physical. Your provider won’t listen to your heart and lungs, order blood work, or diagnose a new condition during this visit. It’s also not the place to bring up a specific health concern like a lingering cough or knee pain.
A standard annual physical involves a comprehensive examination, vital sign checks, and often screening labs like cholesterol or blood sugar panels. It may also address existing conditions and include diagnostic tests like X-rays or EKGs. The wellness visit, by contrast, is purely preventive. It’s a planning session focused on keeping you healthy rather than treating what’s already wrong. If your provider does perform extra tests or address a medical issue during the same appointment, those additional services may trigger separate charges with their own copays and deductibles.
Social Determinants of Health Screening
Starting recently, Medicare also allows providers to add a social determinants of health (SDOH) screening to the wellness visit. This covers factors like housing stability, food access, and transportation challenges that directly affect health outcomes. The SDOH screening is optional, at the discretion of both you and your provider, but when it’s done alongside the Annual Wellness Visit, it’s separately payable with no copay or deductible on your end.
If the screening identifies a need, such as food insecurity or lack of reliable transportation to medical appointments, your provider is required to document it in your medical record. The screening must also be delivered in a way that matches your language, literacy level, and cultural background.
Cost and Eligibility
Medicare Part B covers one Annual Wellness Visit per year, and the HRA is a required component of that visit. You pay nothing out of pocket as long as your provider accepts assignment, meaning they agree to Medicare’s approved payment amount. There’s no Part B deductible for this service.
You become eligible for the Annual Wellness Visit 12 months after your initial “Welcome to Medicare” preventive visit. After that first wellness visit, you can schedule one every 12 months. The HRA questionnaire is typically mailed to you or made available through a patient portal before the appointment so you can complete it ahead of time, though some offices have you fill it out in the waiting room. Either way, arriving with your current medication list and your health history in mind will make the process smoother and more useful.