A Medicare wellness visit is a yearly preventive appointment designed to create or update a personalized plan for keeping you healthy. It’s covered at no cost to you once every 12 months, as long as you’ve had Medicare Part B for at least one year. This visit is not a head-to-toe physical exam. It focuses on screening for health risks, reviewing your prevention strategy, and catching potential problems early.
How It Differs From a Physical Exam
This is the point that trips up the most people. Medicare does not cover routine physical exams. If you go in expecting your doctor to listen to your lungs, check your reflexes, and do a full hands-on examination, that visit will be billed as a routine physical, and you’ll pay 100% out of pocket. The wellness visit is a planning and screening appointment, not a diagnostic one. Your doctor reviews your health history, assesses your risks, checks your vital signs, and maps out which screenings and vaccines you need in the year ahead.
If your provider discovers something during the wellness visit that needs further evaluation, any additional tests, referrals, or follow-up appointments will be billed separately to your insurance. That’s when copays or coinsurance can apply. The wellness visit itself, though, has zero cost sharing as long as your provider accepts Medicare assignment.
The Two Types of Wellness Visits
Medicare actually has two distinct preventive visits, and which one you’re eligible for depends on how long you’ve been enrolled.
The Initial Preventive Physical Exam (sometimes called the “Welcome to Medicare” visit) is a one-time benefit available within your first 12 months of Part B coverage. It includes a review of your medical and social history along with education about preventive services available to you. You can only receive this once in your lifetime.
The Annual Wellness Visit becomes available after you’ve had Part B for more than 12 months. You get one per year going forward. If you skipped your Welcome to Medicare visit, that’s fine. You’re still eligible for the Annual Wellness Visit once that first year passes. The annual version is more comprehensive, built around a formal health risk assessment and a personalized prevention plan that gets updated each year.
What Happens During the Visit
The core of the Annual Wellness Visit is a health risk assessment, which is essentially a structured questionnaire covering a wide range of your physical and mental health. Your provider will collect or review:
- Basic measurements: height, weight, BMI, and blood pressure
- Behavioral risks: tobacco use, alcohol consumption, physical activity level, nutrition, and seat belt use
- Psychosocial risks: depression, stress, loneliness or social isolation, pain, and fatigue
- Functional ability: whether you can handle daily tasks like dressing, bathing, cooking, managing medications, handling finances, and getting around independently
- Fall risk: balance and physical mobility assessments
Your provider also reviews your compliance with recommended screenings (like colonoscopies or mammograms) and checks whether you’re up to date on vaccinations. The goal is to build a written prevention plan tailored to your age, gender, and personal risk factors, then update it each year as your health changes.
Cognitive Screening
Detecting cognitive impairment is a required part of every Annual Wellness Visit. This doesn’t necessarily mean you’ll sit down for a formal memory test. Your provider may screen through direct observation during the visit, or by asking you and any family members present about changes in memory, judgment, decision-making, or medication management. A brief cognitive test may also be used.
If your provider notices signs of cognitive decline, a more detailed assessment can be scheduled. That follow-up evaluation is thorough: it includes standardized dementia staging tools, a review of high-risk medications, screening for depression and anxiety, a safety evaluation covering home environment and driving, and a discussion about advance care planning. This deeper assessment is billed as a separate service but is covered by Medicare.
Who Can Perform the Visit
Your Annual Wellness Visit doesn’t have to be conducted by a physician. Nurse practitioners, physician assistants, and clinical nurse specialists can all perform it. Medicare also allows a team of medical professionals, including health educators, registered dietitians, and other licensed practitioners, to conduct the visit as long as a physician directly supervises them. This flexibility means you may see different members of your care team depending on your practice’s setup.
What to Bring to Your Appointment
Coming prepared makes the visit more useful. CMS recommends bringing four things:
- Medical records and immunization history: especially if you’ve seen specialists or received care outside your primary provider’s system
- Family health history: conditions like heart disease, diabetes, or cancer in parents, siblings, or children
- A complete medication list: every prescription, over-the-counter drug, vitamin, and supplement you take, along with the dose and how often you take each one
- A list of all your current providers: not just doctors, but anyone involved in your care, including home health aides, adult day care services, meal delivery programs, therapists, and behavioral health specialists
Having this information ready lets your provider spend the visit on assessment and planning rather than tracking down records.
What It Costs
The Annual Wellness Visit is covered at 100% under Medicare Part B. You pay no deductible, no copay, and no coinsurance, provided your doctor accepts Medicare assignment. The same applies to the one-time Welcome to Medicare visit during your first year of coverage.
Where costs can appear is at the edges. If your provider orders bloodwork, refers you for imaging, or addresses a specific health complaint during the same appointment, those services are billed separately under standard Medicare cost-sharing rules. If you schedule a separate office visit with your primary care provider shortly after your wellness visit, that follow-up also carries its own costs. The key distinction is between the preventive planning visit (free) and any diagnostic or treatment services that come out of it (billed normally).
How Often You Can Schedule One
Medicare covers one Annual Wellness Visit every 12 months. The clock resets from the date of your last wellness visit, not from the calendar year. So if you had your visit in March 2024, you’re eligible again in March 2025, not January 2025. Missing a year doesn’t affect your eligibility going forward. You can schedule your next one anytime 12 months have passed since the previous visit.