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Medicare Wellness Visits

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Your Medicare Wellness Visits

Welcome to Medicare Visit

Your first visit once obtaining Medicare is called your Welcome to Medicare visit or your IPPE– Initial Preventive Physical Examination.  The goals of the IPPE are health promotion and disease prevention and detection.  Medicare will pay for one IPPE within the first 12 months of your Part B coverage.  Components included in your IPPE are the following:

  •  Medical and social history
  •  Risk factors for potential depression and other mood disorders
  •  Functional ability and safety assessment
  •  Exam includes: height, weight, body mass index, and blood pressure
  •  Other factors deemed appropriate based on medical and social history and current clinical standards
  •  End of life planning
  •  Education, counseling and referral for other preventative services: could include a screening EKG (which is a one-time covered benefit with your IPPE, and co-insurance and deductibles apply).

Mostly this is a history gathering visit and an opportunity to review a variety of health factors.  Medicare does not consider the IPPE a physical examination as you have probably thought of them in the past. Medicare does not cover routine physical examinations.

Your first-time MEDICARE Annual Wellness Visit

Subsequent to your IPPE and after 12 months of Medicare enrollment, you are eligible for an AWV.  Again, this is not a routine physical exam and Medicare does not cover routine physical exams. Components of the AWV include:

  •  Health Risk Assessment
  •  Listing of other providers currently involved in your care
  •  Medical, surgical and family history
  •  Risk factors for depression
  •  Functional and safety risk factors
  •  Obtain height, weight, BMI and blood pressure
  •  Detection of any cognitive impairment
  •  Counseling
  •  Establish written screening schedule for age-appropriate preventive services
  •  List risk factors for which additional interventions are recommended
  •  Advice and referrals to programs and services

Subsequent Annual Wellness Visits

This visit basically updates the information collected at your first AWV and offers education and counseling regarding new information obtained.

Please understand that none of the Medicare wellness visits should be considered a comprehensive physical exam. They are mostly a personalized conversation about how to live a healthy lifestyle given your particular health history.

If a more extensive examination, medical evaluation or treatment is necessary, your provider may continue during the AWV, if time allows.  In that case we will bill for an office visit in conjunction with the wellness visit, and collect a co-pay.  If your insurance applies the charges to your deductible, you will be responsible for the charges.  If additional services are required but are not urgent or the time is not available to continue, a future appointment may be scheduled and fees will apply.

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