What's the Difference Between a Medicare Annual Wellness Visit vs. an Annual Physical?


There are Two Main Differences:

Medicare will Pay for an Annual Wellness Visit, but not an Annual Physical.

The purpose of an Annual Wellness Visit is to establish your baseline health condition and prevent medical problems before they occur. It is fully covered by Medicare as a cost-saving way to keep you healthy.

When making an appointment, be sure to specify that you want to schedule an Annual Wellness Visit in order to prevent getting a costly bill afterward.

Typical things covered in a Wellness Visit:

  • Check height, weight, BMI, blood pressure, etc.

  • Complete and review a Health Risk Questionnaire that may identify personal risk factors that may affect your physical and mental health

  • Look for signs of cognitive impairment

  • Discuss risks based on your personal and family health history

  • Assessment and update prescriptions taken

  • If recommended by your doctor, Medicare also covers preventive services such as preventive cancer and cardiovascular screenings, cholesterol testing, bone density measurement, flu shots, alcohol abuse counseling, etc.

Once your current baseline health condition has been established, you and your doctor can then develop a person wellness program based on your unique health factors.  

If your Wellness Visit exceeds the services covered because your doctor recommends additional testing or treatment, Medicare beneficiaries will typically owe a copay or other charges.

An Annual Physical is Much More Comprehensive than a Wellness Visit

A typical annual physical includes all the services of an Annual Wellness Visit, plus additional services based on your health condition.

Additional services potentially covered in an Annual Physical:

  • Lung exam

  • Head and neck exam

  • Abdominal exam

  • Neurological exam

  • Reflex exam

  • Blood and Urine lab tests 

As a general rule, an Annual Physical includes more in-depth services where the doctor has to “physically” touch you, test you, or take samples from you.

Both are Important

Even if you are in good health, an Annual Wellness visit is important for maintaining your health because it helps diagnose and address health concerns early. Annual physicals are important as a more in-depth health exam addressing specific needs.

I hope this post helps. Please contact me with any questions.

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