Making the Most of Medicare’s Annual Wellness Visit

If you’re looking after an older relative, it’s important to understand how your loved one can benefit from Medicare’s Annual Wellness Visit. The Annual Wellness Visit is a Medicare beneficiary’s yearly appointment with his or her primary care provider to create or update a personalized prevention plan. According to Joshua Hunter, not all Medicare beneficiaries understand how to make the most of this appointment. Joshua, a Public Benefits Specialist at Takacs McGinnis Elder Care Law, a Life Care Planning Law Firm in Hendersonville, Tennessee, offers three tips for maximizing the impact of this important benefit.

Tip #1: Get Current

Think of the Annual Wellness Visit as the time for your loved one to download all of his or her concerns to the doctor. If there have been any recent health scares, now is the time to talk about them. “I advise my clients to talk to their doctor about their family history, previous health scares, and any recent concerns,” Joshua explains. “The goal is to lay things out for your doctor so he or she can create a plan for the coming year. Nothing is too insignificant to share.”

Tip #2: Look Ahead

Though the Annual Wellness Visit isn’t as comprehensive as a full physical, it offers one thing that a physical for a younger person does not: a gateway to a wide range of Medicare-covered preventative services, most of which come at low or no cost to the senior. “There aren’t many free things left in the insurance world, except for Medicare’s preventive services,” notes Joshua. “These services are a great deal for seniors. If you don’t know what those services are, go to or Google the term ‘Medicare Preventative Services’ to find the complete list. Then, take it to your doctor and ask which ones you might need in the coming year or farther down the road.”

Tip #3: Plan Ahead for Medical Necessity

Joshua’s third tip is a pragmatic one. He recommends using the Annual Wellness Visit to establish the medical necessity for services that may be needed in the future. It’s about laying the groundwork today for Medicare to pay for care in the future. When a primary care provider notices something that could be a concern down the road, he or she will note it in the Medicare beneficiary’s record, which will create the paper trail needed for insurance to cover treatment later on. “This is your documentation saying this is medically necessary and I need my insurance to cover it,” says Joshua. “When it comes to insurance coverage, you have to think strategically.”

One of the best parts about the Annual Wellness Visit is that it’s usually completely free. “If your loved one qualifies, Original Medicare covers the Annual Wellness Visit at 100% of the Medicare-approved amount when the service comes from a participating provider,” Joshua notes. “This means you pay nothing—no deductible or coinsurance. Medicare Advantage Plans are required to cover Annual Wellness Visits without applying deductibles, copayments, or coinsurance when the senior sees an in-network provider and meets Medicare’s eligibility requirements for the service.”

Medicare’s Annual Wellness Visit is a great deal for seniors. With a little know-how, you’ll be able to help your elderly loved ones make the most of it.