A Medicare Annual Wellness Visit (AWV) is a yearly preventive appointment covered by Medicare Part B, designed to create and update a personalized prevention plan rather than diagnose or treat existing health problems. It’s available once every 12 months at no cost to you, with no copay, coinsurance, or deductible. The AWV is not a head-to-toe physical exam. It’s a structured check-in focused on screening for health risks, updating your prevention strategy, and catching early signs of cognitive decline or depression.
Who Is Eligible and When
Anyone enrolled in Medicare Part B can receive an Annual Wellness Visit, but there’s a timing rule to know about. Your first AWV cannot take place within 12 months of either your Part B enrollment date or your “Welcome to Medicare” preventive visit (a separate, one-time appointment for new enrollees). After that initial waiting period, you can schedule an AWV once every 12 months going forward.
The “Welcome to Medicare” visit, formally called the Initial Preventive Physical Examination, is a one-time benefit available within your first 12 months on Part B. The AWV is the ongoing annual benefit that picks up after that. You don’t need to have the Welcome to Medicare visit first; you just need to wait 12 months after your Part B coverage starts before your first AWV.
What Happens During the Visit
The AWV has specific required components that distinguish it from a regular office visit. At the core is a health risk assessment, a questionnaire you fill out (often before the appointment) covering topics like your exercise habits, diet, fall risk, mood, and daily functioning. Your provider uses your answers to guide the rest of the visit.
During the appointment, your provider will review and update your medical and family history, go over all current medications and supplements, and compile a list of your other healthcare providers. The visit also includes screening for depression and a cognitive assessment, which typically involves brief tasks like word recall or backward counting to check for early signs of memory problems. Medicare requires “detection of any cognitive impairment” through direct observation and, when appropriate, a validated screening tool. This doesn’t mean a full dementia workup. It’s a brief check that flags whether further evaluation is needed.
Your provider will also assess functional ability and safety concerns, such as fall risk, hearing, and your ability to manage daily activities. Based on everything gathered, the visit produces a personalized prevention plan of service. This plan maps out a screening schedule spanning 5 to 10 years, including which preventive tests and vaccinations you should receive and when. It also includes counseling on health risks identified during the assessment.
First Visit vs. Subsequent Visits
Medicare distinguishes between your first AWV and every one after it. The first visit establishes your baseline: a full health risk assessment, a complete medical and family history, and your initial personalized prevention plan. You can only have one “first” AWV in your lifetime.
Subsequent visits, which occur annually from that point on, follow the same structure but focus on updates. Your provider reviews an updated health risk assessment, checks for changes in your medical history, reassesses your medications and supplement list, repeats the cognitive and depression screenings, and revises your prevention plan based on any new risk factors. The visit also revisits your list of providers and any educational counseling programs relevant to your current health risks.
What It Costs
The AWV itself is covered at 100% by Medicare Part B. You pay nothing out of pocket as long as the visit stays within its preventive scope. However, costs can come into play if your provider addresses a separate medical issue during the same appointment. If you bring up a new symptom or your provider identifies a condition that requires evaluation and treatment during the visit, that portion gets billed as a separate office visit, which is subject to your normal Part B deductible and coinsurance.
Certain add-on services are also covered without extra cost when bundled with the AWV. Advance care planning, where you discuss end-of-life preferences and directives with your provider, is covered once per year with no coinsurance or deductible when delivered during the same AWV appointment by the same provider. A social determinants of health risk assessment, which screens for challenges like food insecurity, housing instability, or transportation barriers, is similarly covered at no cost once per year when performed during the AWV. Outside the AWV, both of these services carry standard cost-sharing.
How It Differs From a Physical Exam
The most common point of confusion is expecting a traditional physical when you show up for an AWV. Medicare does not cover routine physical exams. The AWV is strictly a planning and prevention visit. Your provider will not typically listen to your heart and lungs, press on your abdomen, or perform the kind of hands-on examination associated with an annual physical. There are no blood draws or lab tests included as part of the AWV itself, though your provider may order labs separately based on what the visit reveals.
Think of the AWV as a strategy session. It’s where you and your provider step back from managing day-to-day health issues and instead look at the bigger picture: what screenings you’re due for, what risks are emerging, whether your medications still make sense, and whether there are early signs of cognitive or functional changes worth tracking. If you want a traditional physical exam, you’ll need to schedule a separate office visit, which will be billed under standard Part B rules with applicable cost-sharing.
How to Prepare
You’ll get more out of your AWV if you come with a few things ready. Bring a complete list of every medication and supplement you take, including doses. Have the names and contact information of all your healthcare providers, specialists, and any facilities where you’ve had recent care. If you have records of recent screenings, immunizations, or test results from outside providers, bring those too.
Many practices send the health risk assessment questionnaire ahead of time, either by mail or through a patient portal. Filling it out before you arrive saves time and lets your provider review your responses in advance. If you or a family member has noticed any changes in memory, mood, or daily functioning since your last visit, make a note to mention those. The cognitive and depression screenings during the AWV are brief, and your own observations add valuable context that a short in-office test might not capture.