Patient with primary care provider
April 24, 2019 | by The Polyclinic

At The Polyclinic, we want to keep you healthy, out of the hospital, and doing what you love. One great way to stay healthy is to take advantage of the preventive visits covered by Medicare. The Welcome to Medicare Visit and the Annual Wellness Visit (also known as an AWV) are not the same as a traditional physical exam and have specific benefits and coverage defined by Medicare.

Welcome to Medicare Visit is a Preventive Visit Covered by Original Medicare

As the name suggests, you are eligible for the Welcome to Medicare visit within the first 12 months of enrolling in Medicare Part B. Medicare Advantage plans cover the same preventive services as Original Medicare when you see in-network providers, including your designated primary care provider.

During this initial visit, your doctor will:

  • Review your current prescriptions, health and medical history
  • Check your height, weight, and blood pressure
  • Calculate your body mass index (BMI)
  • Conduct a simple vision test
  • Review potential risk for depression and other mental health conditions
  • Discuss disease prevention, health, and wellness improvements

After the assessment, your doctor will share a personalized care plan with recommendations for screenings, immunizations, and other preventive services. You will be billed separately for any services or screenings not covered by Medicare, so additional health concerns may require a separate follow-up appointment.

After your initial Welcome visit, you’ll start receiving Annual Wellness Visits to review your medical conditions, and how to manage them and prevent complications. You are eligible for an AWV every 12 months if you have been enrolled in Medicare Part B longer than 12 months.

What to bring to each visit:

  • Medical and immunization records from outside providers
  • Family health history
  • A list of your prescriptions and over-the-counter medications, including supplements

AWV is Different from a “Head-to-Toe” Physical

The traditional annual physical is an examination to check your vital signs, heart, lungs, head, neck, abdomen, reflexes, and skin. A wellness visit is considered a ‘hands-off’ visit focused on health history, risk factors, review of age-appropriate screenings, and education on disease management and self-care.

During this visit, your doctor will:

  • Update your medical history, including a list of your providers and prescriptions
  • Discuss disease prevention, health, and wellness improvements
  • Check your height, weight and blood pressure
  • Review your personal plan of care, including what health screenings are covered by Medicare

In addition to the AWV, Medicare beneficiaries can access many free preventive care services, such as cardiovascular disease screenings, prostate cancer screenings, and mammograms.

Schedule Your AWV

Insurance coverage depends on timing and your plan. While annual physicals are not covered by Medicare, both traditional annual physicals and wellness visits are covered by most Medicare Advantage plans. For patients with Original Medicare Part B with or without a supplement plan, schedule your AWVs one full year (365 days) apart to ensure insurance coverage. For patients with a Medicare Advantage plan, schedule one AWV per calendar year to ensure coverage (January-December). Exceptions may apply for some plans.

Contact our Polyclinic Population Health Team at 206-860-5510, Monday-Friday, 8 am – 5 pm

They are dedicated to helping you understand and schedule your annual wellness and preventive visits when you are on a Medicare, Medicare Supplement, or Medicare Advantage plan at The Polyclinic.