Medicare wellness visits don't have to be 12 months apart — you can have one every year, and you can schedule the next one as soon as your current visit ends.

A Medicare Annual Wellness Visit is covered once per calendar year if you have Original Medicare and have had it for at least 12 months. The "12 months" rule refers to your may be able to access window, not the spacing between visits. Once you've had a wellness visit in January, you're may be able to access for another one starting in December of that same year. You don't have to wait until the following January.

The visit itself takes about 15 to 20 minutes and includes a health history review, measurements like blood pressure and weight, a list of your current medicines, and a personalized prevention plan. Your doctor or nurse practitioner will note any health risks and suggest screenings or vaccines you may need. There's no copay, coinsurance, or deductible if your provider is in-network and bills it correctly.

Key Takeaways

  • You can schedule a wellness visit once per calendar year if you have Original Medicare and have had it for at least 12 months.
  • The visit is fully covered with no out-of-pocket cost when performed by an in-network provider.
  • You don't have to wait a full 12 months between visits — you can schedule your next one as soon as your current visit is complete.
  • The personalized prevention plan your doctor creates is the most useful part of the visit and should guide your preventive care for the year ahead.

What happens during a Medicare wellness visit

Your doctor or nurse practitioner will review your complete health history, including past illnesses, surgeries, and current symptoms. They'll take your vital signs — blood pressure, weight, height, and sometimes pulse and temperature. They'll also ask about your medicines, including over-the-counter drugs and supplements, and check whether you're taking them as prescribed.

The provider will perform a brief physical exam and may order lab work or screenings based on your age and health history. Common screenings include cholesterol checks, diabetes screening, colorectal cancer screening, and bone density testing. At the end of the visit, your doctor will give you a written personalized prevention plan that lists the screenings, vaccines, and lifestyle changes recommended for you. This plan is yours to keep and refer to throughout the year.

When you become may be able to access for your first wellness visit

You must have had Original Medicare for at least 12 months before you can have your first wellness visit. If you enrolled in Medicare on March 15, your first wellness visit window opens on March 15 of the following year. After that, you're may be able to access once per calendar year.

If you switched from a Medicare Advantage plan to Original Medicare, the 12-month clock starts from the date your Original Medicare coverage began, not from when you first enrolled in any Medicare plan. Call Medicare at 1-800-MEDICARE if you're unsure of your may be able to access date.

How to schedule your wellness visit

Contact your primary care doctor's office directly and ask to schedule your Annual Wellness Visit. Tell them you have Original Medicare and want to book the preventive visit. Many offices have a standing appointment slot for wellness visits and can fit you in within a few weeks.

If you don't have a primary care doctor, you can see any doctor who accepts Medicare, including a nurse practitioner or physician assistant in a clinic setting. Bring your Medicare card and a list of all your current medicines, including dosages. If you've had recent lab work done elsewhere, bring those results too — it saves your doctor time and may prevent duplicate testing.

What to bring and how to prepare

Bring your Medicare card, a photo ID, and a current list of all medicines and supplements you take. Write down any health concerns or changes you've noticed since your last visit — new aches, sleep problems, memory issues, or mood changes. If you've had blood work, imaging, or other tests done in the past year, bring those records or ask your previous provider to send them.

Wear comfortable, loose-fitting clothes so your blood pressure can be taken accurately on your arm. If you take blood pressure medicine, take it as usual before your visit unless your doctor has told you otherwise. Arrive 10 to 15 minutes early to allow time for check-in.

Coverage and costs

Original Medicare covers the Annual Wellness Visit at no cost to you when your provider is in-network and bills it as a preventive service. You pay nothing for the visit itself, and you don't have to meet your deductible first. However, if your doctor finds a problem during the visit and provides treatment for that problem in the same visit, you may owe a copay for the treatment portion.

For example, if your wellness visit reveals high blood pressure and your doctor prescribes medicine to manage it, the prescription is separate from the wellness visit and you may owe a copay. The wellness visit itself remains free. If your provider is out-of-network, you may owe 20% of the Medicare-approved amount, so confirm your doctor's network status before scheduling.

What to do with your personalized prevention plan

Your doctor will give you a written prevention plan at the end of your visit. This plan lists your health risks, recommended screenings, vaccines you may need, and lifestyle changes like diet or exercise. Keep this document and refer to it throughout the year. Share it with any specialists you see, because it helps them understand your overall health picture.

If your plan recommends a screening — such as a colonoscopy or mammogram — ask your doctor's office for a referral or the name of a facility where you can have it done. Some screenings are covered by Medicare at no cost if they're done within the recommended timeframe. Your prevention plan is a roadmap for staying healthy, not just a piece of paper to file away.

Frequently Asked Questions

Can I have a wellness visit if I'm on a Medicare Advantage plan?

No. The Annual Wellness Visit is only covered under Original Medicare. If you have a Medicare Advantage plan, your plan may offer its own preventive visit or health assessment, but it's not the same as the Medicare wellness visit. Contact your plan to ask what preventive services they cover.

What if I miss my wellness visit window during the calendar year?

You can still have a wellness visit at any time during the year. The "once per calendar year" rule means Medicare will pay for one visit per year, but there's no penalty for having it in February instead of January. You're may be able to access again on January 1 of the following year.

Do I need a referral from my primary care doctor to have a wellness visit?

No. You can call any in-network doctor or clinic directly and ask to schedule your Annual Wellness Visit. You don't need a referral. If you don't have a primary care doctor, you can see a nurse practitioner or physician assistant at a community health center or urgent care clinic that accepts Medicare.

Will my wellness visit cover a specific health problem I'm worried about?

The wellness visit is designed to review your overall health and catch problems early through screening and prevention. If you have a specific symptom or concern, mention it during the visit, but if your doctor needs to diagnose or treat that problem, that portion may be billed separately and you may owe a copay. For ongoing health issues, schedule a separate sick visit with your doctor.

Can I have my wellness visit done over the phone or video?

Medicare covers telehealth wellness visits, but your provider must offer them and bill them correctly. Some doctors' offices do offer virtual wellness visits, especially for the history and prevention plan portion. Call your doctor's office and ask whether they offer virtual wellness visits and whether they're covered the same way as in-person visits.