Understanding different types of annual check-ups and how Medicare can help

Nurse explaining diagnosis to older man

At the start of a new year, many of us will be thinking about improving our health. One of the easiest ways to take charge of your health is by scheduling regular visits with your doctor. Taking the extra time annually for these checkups can drastically improve your overall wellness and help you live life boldly!

According to JAMA Internal Medicine, adults with a primary care provider (PCP) are more likely to receive preventive care and fill their prescriptions. This proactive preventive care may identify health concerns earlier, since your PCP knows your medical history and can monitor chronic conditions, like Type 1 and Type 2 diabetes.

To help manage your health throughout the year, we encourage you to attend regular doctor’s appointments and recommend taking advantage of the preventive care appointments available to you, including a “Welcome to Medicare” visit, an annual “Wellness” visit and an annual physical exam. Here’s some important information about the benefits of each type of visit:

What is a “Welcome to Medicare” visit?

This is a one-time preventive visit that takes place during the first 12 months after you enroll in Medicare Part B. This appointment provides a great opportunity for you to work with your doctor to get ahead of any illnesses or health issues so you can continue living boldly. During this visit, you can address vaccination history, mammograms, risk factors and more. You’ll have an opportunity to review your medical and social history, education and counseling about preventive services like flu screenings, a calculation of your body mass index (BMI) and a review of your potential risk for depression.

What is an annual “Wellness” visit?

Once you’ve had Medicare Part B for longer than 12 months, you may be eligible for an annual “Wellness” visit. The goals of this visit are to prevent disease or disability based on your current health and risk factors. Please note that the yearly “Wellness” visit is not a physical exam. Be sure to communicate with your doctor about how you can schedule both your “Wellness” visit and yearly physical exam at the same time.

What is an annual physical exam?

An annual physical exam is more extensive than an annual “Wellness” visit. Your annual “Wellness” visit includes assessments but no physical contact with the provider unless you have a specific diagnosis. Your annual physical includes a physical exam, and your provider will check your weight, height and body mass index (BMI).

Does Medicare cover these annual visits?

Your Medicare plan may cover some or all of these visits. Specifically:

  • Original Medicare does not cover your annual physical exam, but you pay nothing for the “Welcome to Medicare” visit and annual “Wellness” visits if your doctor or other qualified health care provider is in-network and meets the specifications from Medicare. 
  • Medicare Advantage may cover all three types of check-ups: your “Welcome to Medicare” visit, an annual wellness visit and, depending on your plan, your annual physical exam. ApexHealth Medicare Advantage plans, for example, cover an annual routine physical at $0 cost-share to you. 

We hope that learning more about opportunities for regular doctor’s appointments covered by Medicare can help you stay healthy this year. If you need help finding a doctor or scheduling your visits, our Apex Assistants have you covered! Give us a call at (844) 279-0508 (TTY: 711). Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31.


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