Annual Medicare Wellness Visit

The Annual Medicare Wellness Visit is not a Physical.
I had previously thought it was.

Does it benefit the patient?
What do you think of it?

I’m not familiar with it? Do you have original Medicare or an Advantage plan?

I am looking for opinions of those who have experienced it.
It is available to both Advantage and Regular Medicare though it seems that Advantage plans push it harder.
It is free to the patient.
The Dr or Advantage plan receives extra Medicare payment for conducting Wellness visits.

I’m not on Medicare, so can’t answer your question.

Here’s some more info on the differences between the two

I just had an annual well-adult visit, and it seemed to be a combination of both, the same way it’s been for the last 10 years or so.

I think we, as a country, need to change from being reactive – treating illnesses – to being proactive – educating our people to help them stay healthy, so if that’s what this Medicare Wellness Visit is, I’m generally in favor. The video mentioned “Medicare will pay for it” a few too many times to my liking, so I wonder if something else besides patient health is behind the sales pitch.

Annual physicals were first proposed after World War II when there were lots of doctors fresh out of the military who didn’t have much to do. Job security…

I have had Physicals from Kaiser in the past and now have Wellness visits with them and never noticed any difference in them. I just thought it was a new name or new term used.

I think wellness home visits benefit the insurance industry. I opted for one once and felt that the rep, who was not a qualified nurse, spent more time asking questions that related to risk of the insurer than of potential benefit to me.

I’ll bet the info gathered from these *home visit sessions goes straight to the folks who assess risks and set future insurance rates.

My primary care physician gives me a physical exam once a year.

*home visit appointments are pushed by United Health Care

When you all go to the doctor for a physical, do you bring up problems you’ve had since the last one?

Perhaps another difference between physical and wellness visit is that you’re not supposed to discuss chronic problems or new issues at the wellness visit. You’re supposed to make separate appointments and come back later for those. (more job security)

I know when I go in for a “Wellness” visit, it’s basically a physical. All of those basic wellness things get coded as such and are generally covered 100% by insurance. But, if you discuss other things outside of the wellness stuff, that’s coded differently and I will get charged for it. It’s still much cheaper than making a separate appointment.

In the wellness exam the doctor has a set of routine questions about any recent deaths in the family, suicidal thoughts, connive ability (copy a pair figures, spell “world” back wards, write a complete sentence, what county do you live in, what is todays date etc.

In the one’s I have been to they also include what I consider routine examinations and a blood draw.

I visit my PC doc twice a year. One of those visits includes the annual Medicare required questions. Forget exactly but things like stairs in the house, are there handrails, any falls, any problems doing things, any depression, flu shot, basic vision check, etc. if you are unaware of the annual requirement you probably would not even notice it.

I visit my primary care doctor when i have a health issue. I see my pulmonologist at least every six months for a routine checkup, which includes regular tests on my breathing ability. I get sufficient, but barely, time with primary care. I get plenty of time with my pulmonologist, and lots of discussion.

And at Kaiser there is no copay to see your Primary Care.
Yet Medicare pays Kaiser to conduct these Wellness Visits, which are done by a PA.

Seems there is little benefit to the patient.
One wonder if the main purpose of the Wellness Visit is Medicare gathering statistical information.

After Covid one wonders about how the Government uses or abuses statistical info.

I would posit that it is more an attempt to keep senior citizens mobile, alert, healthy and living safely in their homes and out of hospitals longer. Assuming the senior answers truthfully, it provides an opportunity for education/intervention. Identifying and dealing with issues that interfere with these goals should be a win-win for the seniors and for taxpayers.

Between original medicare and tricare for life, I have never had to pay copays/cost shares (except for meds) or deductibles.

When I say my primary care doctor, I am actually referring to her office. Most of my visits that need immediate attention, I end up with one of the PAs, it depends on schedules. They definitely do triage…have a cat bite and they will always get you in that day. Things that can wait a day or two may take that long. Well care or things that are not urgent, I always get my MD.

My regular DR. gives me my wellness check at Kaiser. I’m 59, on SSDI and on Medicare if that makes a difference. I really can’t tell the difference on what they do for a physical or a wellness check, maybe it depends upon your age.

‘Annual Health Assessment’ they hound you by phone to set it up and also give you a $50 gift certificate. So if its free money to the provider from Medicare then I can see why. They ask the same questions each time. Take your blood pressure, and heart and lung check and then the charge on your statement is from some doctor you’ve never heard of. basically a total waste of time and they know it that’s why they reel you in with the $50 freebie.

I feel like it’s a waste of my time. I’m not allowed to discuss any new issues. I have to come back for that or else the provider can’t bill it as a “Wellness” visit. Well, aren’t new issues related to my wellness?

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Here is the form they gave me to fill out before my appointment. See attached.

With Kaiser, I just log into my account and send a question to my Primary, any time I want. The primary will evaluate and offer suggestions, schedule an appointment or prescribe something.

When I had my periodic wellness tests, the person conducting it could enter items in my record about things they see, but they are not prepared nor trained as a doctor would be. Thus you would not bring up items for them to address.


I’m furious that I have to wait for a month and a half finally June 1st for an appointment because they have to bill it as a wellness check when it was way more than that!