What are the three types of Medicare wellness visits?
Asked by: Tate Vandervort DVM | Last update: August 5, 2025Score: 5/5 (33 votes)
- Initial Preventive Physical Exam (IPPE)
- Initial Annual Wellness Visit (AWV)
- Subsequent AWVs.
What is the difference between a preventive visit and a wellness visit?
Preventive care is things like getting your yearly check ups, your vaccinations, things like that to keep you from getting sick. And then wellness care would be like, "I'm sick I should go to the doctor now."
What are the three words for Medicare Wellness exam?
During a Medicare Wellness Visit, you might be asked to remember three words as part of a cognitive assessment. The three words commonly used are “banana, sunrise, and chair”. This test helps doctors check your memory and cognitive function.
What is not covered in a Medicare annual wellness visit?
Medicare does not cover Annual Wellness Visits if they are used to discuss, plan, or alter treatment for pre-diagnosed chronic illnesses, including high cholesterol, high blood pressure, or arthritis.
What does a Medicare wellness appointment consist of?
At your Medicare annual wellness visit, your health care provider will: Review your blood pressure, heart rate, height, weight and body mass index (BMI). Review your current health problems, as well as your medical, surgical, family and social histories. Review your current medications.
What are Medicare's Rules and Requirements for Annual Wellness Visits (AWV)?
Is bloodwork part of a wellness visit?
Does a Wellness Exam Include Blood Work? Yes, a wellness exam can include blood work. However, it's important to note that the specific tests conducted during a wellness exam may vary from person to person.
How many doctor visits does Medicare cover for seniors?
Medicare does not limit the number of times a person can consult their doctor, but it may limit how often they can have a particular test and access other services. Individuals can contact Medicare directly at 800-MEDICARE (800-633-4227) to discuss physician coverage in further detail.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
What is not included in a wellness exam?
Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit. The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care.
Does Medicare annual wellness visit include labs?
No. The IPPE and AWV don't include clinical lab tests, but you may make appropriate referrals for these tests as part of the IPPE or AWV.
What is the 5 word memory test for Medicare?
The 5-Word Memory Test is designed to be quick and simple. It evaluates an individual's short-term memory and recall capabilities, which are often affected in the early stages of dementia.
Can I refuse the Medicare annual wellness visit?
People can refuse a Medicare annual wellness visit, but it is worth considering the potential benefits. Wellness visits can help healthcare professionals detect health issues early on and are an important part of preventive care.
How much does Medicare pay for a wellness check?
With Medicare Part B, you can get a wellness visit once a year at no cost to you. Check to make sure the doctor or nurse accepts Medicare when you schedule your appointment.
Is a breast exam part of a Medicare wellness visit?
Medicare covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer.
Is blood work considered preventive care?
Not all routine blood tests are preventive (e.g., thyroid tests are generally not preventive). Not all 'screening' doctors' office visits are preventive (e.g., total body skin exams by dermatologists are usually not considered preventive).
Why doesn't Medicare pay for annual physicals?
Annual physicals aren't covered by traditional Medicare because they are excluded by the federal law that governs Medicare. All Medicare plans cover a Welcome to Medicare exam during your first 12 months with Medicare and in subsequent years, an annual wellness exam.
Is blood work included in a wellness visit?
Although there are no definite rules about which laboratory tests should be included in an annual wellness exam, most doctors prescribe routine tests for better insight into an individual's medical condition. These tests may include urinalysis, complete blood count and picture, and chemistry panel.
What not to do before a wellness check?
- Consuming alcohol.
- Drinking caffeine within an hour of your visit.
- Eating a high-fat meal before bloodwork.
- Eating or drinking anything for eight to 12 hours, or as directed by your provider, before bloodwork that requires a fast.
- Taking cold medicine if you're feeling under the weather.
What is considered an abnormal finding on a wellness exam?
Abnormal finding represents any non-clinically significant abnormal symptoms/disease that have been newly diagnosed or have worsened since last visit (or since informed consent for baseline visit).
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
What are 3 services not covered by Medicare?
We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.
What blood tests does Medicare not cover for seniors?
It's important to know that Medicare won't cover any blood test if it isn't medically necessary. If you seek a blood test on your own, it's unlikely you'll get it covered. Tests not covered may include those for employment purposes, wellness screenings, or routine monitoring without medical necessity.
Does Medicare cover 100% of hospital bills?
Whether you're new to Original Medicare or have been enrolled for some time, understanding the limitations of your coverage is important as you navigate decisions about your healthcare. One of the main reasons why Original Medicare doesn't cover 100% of your medical bills is because it operates on a cost-sharing model.
Does Medicare cover eye exams?
Routine eye care services, such as regular eye exams, are excluded from Medicare coverage. However, Medicare does cover certain eye care services if you have a chronic eye condition, such as cataracts or glaucoma. Medicare covers: Surgical procedures to help repair the function of the eye due to chronic eye conditions.