What Medicare's Annual Wellness Visit Covers

Medicare Part B covers one wellness visit per year at no cost to you — no copay, no deductible. This visit is different from a regular checkup. A doctor or nurse practitioner reviews your overall health, checks your blood pressure and weight, screens for depression and cognitive problems, and updates a written plan for your care. The visit takes 15 to 30 minutes and focuses on prevention and catching problems early, not on treating an illness you already know about.

The wellness visit is sometimes called the "Annual Wellness Visit" or "preventive visit." It is separate from any sick visits or routine exams you may have. You can have this visit once every 12 months, and it must happen at a doctor's office or clinic — not by phone or video.

Key Takeaways

  • Medicare Part B covers one wellness visit per year with no out-of-pocket cost if you see an in-network provider.
  • The visit includes a health review, blood pressure and weight check, depression screening, and a written care plan you take home.
  • You must have had Part B for at least 12 months before your first wellness visit, though you can schedule it anytime after that.
  • If your doctor finds a problem during the wellness visit and you need treatment, that treatment visit may have a copay or deductible.
  • You do not need a referral, but calling ahead to schedule ensures the appointment is set up as a wellness visit, not a regular office visit.

Who Can Have a Medicare Wellness Visit

You must be enrolled in Medicare Part B and have had it for at least 12 months. This means if you just turned 65 and signed up for Part B, you can schedule your first wellness visit after you have been covered for a full year. After that first year, you can have one wellness visit every 12 months for as long as you have Part B.

The visit is available whether you have Original Medicare alone, Original Medicare plus a Medigap plan, or Original Medicare plus a Medicare Advantage plan. If you have a Medicare Advantage plan, check your plan documents or call the plan to confirm the wellness visit is covered the same way — most plans do cover it, but the details can vary.

What Happens During the Wellness Visit

Your doctor or nurse practitioner will take your blood pressure, measure your height and weight, and calculate your body mass index (BMI). They will ask about your medical history, any medications you take, and any falls or injuries you have had. They will screen you for depression using a short questionnaire and may ask questions about your memory and thinking to screen for cognitive problems.

The provider will review your shots and preventive screenings — mammograms, colonoscopies, bone density tests, and others — to see which ones you are due for. They will talk with you about diet, exercise, and safety at home. At the end, they give you a written summary of the visit and a list of any preventive services you should have. This document is yours to keep and share with other doctors.

How to Schedule Your Wellness Visit

Call your primary care doctor's office or the clinic where you usually go. Tell them you want to schedule your annual wellness visit under Medicare. This is important: if you just say you want a checkup or physical, the office may schedule it as a regular office visit instead, which could mean a copay. Saying "annual wellness visit" or "Medicare preventive visit" tells them to bill it the right way.

If you do not have a regular doctor, you can go to an urgent care clinic, a community health center, or any doctor who takes Medicare. Call ahead to confirm they accept Medicare and that they can do a wellness visit. You will need to bring your Medicare card.

What Costs You Nothing and What Might Cost You

The wellness visit itself is free under Part B — no copay, no deductible, no coinsurance. This is true whether you have Original Medicare or a Medicare Advantage plan. However, if the doctor finds something that needs treatment during the wellness visit, that treatment is a separate service and may have a cost.

For example, if your blood pressure is high and the doctor prescribes medication, the medication is not part of the wellness visit — it is a treatment, and you may have a copay or deductible depending on your plan. If the doctor orders blood work or an X-ray during the wellness visit, those tests may also have a cost. Ask your doctor before they order anything whether it is included in the wellness visit or whether it will be billed separately.

Preventive Services You May Hear About During Your Visit

During your wellness visit, your doctor will talk about screenings and shots you may be due for. Medicare Part B covers many of these at no cost, including mammograms, colonoscopies, bone density scans, and flu shots. Your doctor will tell you which ones you need based on your age and health history.

Some preventive services are covered once every few years, and some are covered once per year. For example, a mammogram is covered once every 12 months, and a colonoscopy is covered once every 10 years if the results are normal. Your doctor will explain the timing and help you schedule any tests you need. These screenings are separate from the wellness visit itself, but the wellness visit is a good time to plan them.

Frequently Asked Questions

Do I need a referral to have a wellness visit?

No. You can schedule a wellness visit directly with any doctor who takes Medicare without a referral. If you have a Medicare Advantage plan, check your plan rules — some plans require you to use your primary care doctor for the wellness visit, but most do not require a referral.

Can I have a wellness visit by phone or video?

No. Medicare requires the wellness visit to happen in person at a doctor's office or clinic. Telehealth visits do not count as your annual wellness visit, though you can have other types of visits by video.

What if I have already had a regular checkup this year?

You can still have your wellness visit. A regular sick visit or checkup for a specific problem is different from a wellness visit. You are may have access to to one wellness visit per year even if you have seen your doctor for other reasons.

Will the wellness visit show me if I have a serious disease?

The wellness visit is a screening tool, not a diagnosis. It checks your basic health numbers and asks about your habits and symptoms. If the doctor finds something that needs more testing, they will order those tests. The wellness visit itself does not diagnose diseases, but it can catch early signs that something needs attention.

What if I turn 65 in the middle of the year?

You must wait 12 months from the date your Part B coverage starts before you can have your first wellness visit. If you turn 65 in June and Part B starts in June, your first wellness visit can happen in June of the following year.