Quick Answer
The Medicare Annual Wellness Visit is a free preventive appointment covered by Medicare Part B once every 12 months. It includes a health risk assessment, review of your medical and family history, a personalized prevention plan, and referrals for recommended screenings. There is no copay or coinsurance when you see a participating provider. It is not the same as a routine physical exam.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare (Part A & B) | Covered | $0 cost once every 12 months; no deductible or coinsurance when billed as a preventive visit |
| Medicare Advantage (Part C) | Covered | Required to cover the AWV at $0; many plans offer additional wellness benefits |
| Medicare Supplement (Medigap) | No Cost-Sharing Needed | No out-of-pocket cost for the AWV itself; Medigap not needed for this visit |
| Medicare Part D | Not Applicable | The AWV is a service, not a prescription; medications discussed may be covered under Part D |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Medicare Part B covers the Annual Wellness Visit once every 12 months at no cost to you. The visit includes a health risk assessment, review of your medical and family history, a current list of providers and medications, blood pressure and other routine measurements, personalized health advice, and a schedule of appropriate preventive screenings and referrals.
Note that the AWV is not a head-to-toe physical exam. If your doctor performs additional services during the same visit, you may be billed separately for those services and standard Part B cost-sharing will apply.
Medicare Advantage (Part C)
Medicare Advantage plans are required to cover the Annual Wellness Visit at $0 cost-sharing. Many plans also offer additional wellness benefits such as fitness programs, nutrition counseling, and chronic disease management that go beyond the standard AWV.
Medicare Supplement (Medigap)
Because the Annual Wellness Visit has no cost-sharing under Original Medicare, a Medigap plan is not needed to cover the visit itself. However, if additional services are performed during the same appointment, Medigap can help cover the Part B coinsurance for those services.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.