From the Guidelines
A Medicare wellness exam should be scheduled annually as it is fully covered with no copay and helps identify health risks early, establish baseline measurements, and ensure receipt of appropriate preventive services. This exam is an annual preventive visit covered by Medicare Part B that focuses on health promotion and disease prevention rather than treating specific problems 1. During the visit, your healthcare provider will review your medical history, assess your risk factors, perform a health risk assessment, check vital signs, and create a personalized prevention plan. The exam typically includes screenings for depression, cognitive impairment, fall risk, and functional ability. Key aspects of the Medicare wellness exam include:
- Review of medical history and risk factors
- Health risk assessment and personalized prevention plan
- Screenings for depression, cognitive impairment, fall risk, and functional ability
- No comprehensive physical examination or lab tests, unless ordered separately if needed The initial visit is called the "Welcome to Medicare" preventive visit if done within the first 12 months of Medicare Part B enrollment, while subsequent annual visits are called "Annual Wellness Visits" 1. These exams are valuable because they help maintain health and independence as you age, and are supported by the Affordable Care Act (ACA) which requires Medicare to cover annual wellness visits and personalized prevention plan services to all beneficiaries 1.
From the Research
Medicare Wellness Exam
- The provided studies do not directly address the topic of Medicare wellness exams.
- However, they do discuss the prevalence of certain health conditions, such as hypertension, type 2 diabetes, and hyperlipidemia, which may be relevant to wellness exams 2, 3, 4.
- A study published in the Journal of clinical hypertension found that among hypertensive patients, the prevalence of type 2 diabetes mellitus and hyperlipidemia was 12.79% 2.
- Another study published in High blood pressure & cardiovascular prevention found that elevated levels of triglycerides and low-density lipoprotein cholesterol were associated with all grades of hypertension, while high levels of high-density lipoprotein cholesterol were linked to more severe hypertension 3.
- A cross-sectional study published in the Journal of education and health promotion found that approximately 10% of participants had diabetes, 15% had hypertension, and 32% had dyslipidemia, and that the prevalence of these conditions increased with increasing body mass index 4.