Medicare Wellness Visits Explained

Last updated: July 2, 2026

Quick Answer: A Medicare wellness visit is a free, annual preventive care appointment covered under Medicare Part B. It is not a physical exam in the traditional sense. Instead, it focuses on reviewing your health history, identifying risk factors, and creating a personalized prevention plan. There is no copay or deductible when you see a Medicare-enrolled provider.

Key Takeaways

• Medicare covers one Annual Wellness Visit (AWV) per calendar year at no cost to the patient when billed correctly.
• The visit is not the same as a routine physical exam. It focuses on prevention and health risk assessment, not hands-on diagnosis.
• A Welcome to Medicare visit (IPPE) is a one-time benefit available within the first 12 months of Part B enrollment.
• Patients on Medicare Advantage plans are also entitled to wellness visits, often with additional benefits.
• Bring a complete medication list, your health history, and any recent lab results to get the most out of your visit.
• Missing your wellness visit does not result in a penalty, but it does mean a missed opportunity to catch health risks early.
• Preventive screenings such as diabetes testing, cholesterol panels, and blood pressure checks can be ordered during or alongside the visit.
• Patients with chronic conditions like diabetes, hypertension, or high cholesterol benefit most from consistent annual wellness visits.

What Is a Medicare Wellness Visit and What Does It Cover

A Medicare Annual Wellness Visit (AWV) is a yearly appointment designed to help Medicare beneficiaries stay ahead of health problems rather than react to them. It is covered under Medicare Part B as a preventive service, meaning eligible patients pay nothing out of pocket when they visit a Medicare-enrolled provider.

The visit covers several key components:

• Health risk assessment: A questionnaire covering your medical and family history, current medications, and lifestyle factors such as diet, physical activity, and tobacco use.
• Vital measurements: Height, weight, body mass index (BMI), blood pressure, and other routine measurements.
• Cognitive assessment: A brief evaluation to screen for signs of cognitive impairment or memory concerns.
• Depression screening: A standardized tool to identify signs of depression or emotional health concerns.
• Functional ability review: An assessment of your ability to perform daily activities and any fall risk factors.
• Personalized prevention plan: A written plan that outlines recommended screenings, immunizations, and referrals based on your individual health profile.

What the AWV does not include: hands-on physical examination of organ systems, diagnosis of new conditions, or treatment of existing problems. If your doctor identifies a new concern during the visit, that service may be billed separately and could involve a copay.

How Often Can You Get a Medicare Wellness Visit Per Year

Medicare covers one Annual Wellness Visit per calendar year. To qualify for a second visit in the same calendar year, 12 full months must have passed since your last AWV.

There is also a separate, one-time benefit called the Initial Preventive Physical Examination (IPPE), sometimes called the “Welcome to Medicare” visit. This is available only once, within the first 12 months of enrolling in Medicare Part B. It includes a review of your medical and social history, a physical examination, and counseling on preventive services.

Decision rule: If you are newly enrolled in Medicare Part B, schedule your IPPE first. Once that 12-month window closes, you transition to the annual AWV cycle.

Is There a Cost for Medicare Wellness Visits

No. Medicare wellness visits are free for patients when the following conditions are met:

• The provider accepts Medicare assignment (is enrolled in Medicare).
• The visit is billed correctly as a preventive wellness visit, not as an office visit for a new or existing condition.
• The patient has met their Part B enrollment requirements.

Important edge case: If your doctor addresses a separate medical problem during the same appointment, that portion of the visit may be billed as a regular office visit. That additional service can trigger a copay or deductible. Patients should clarify at the start of the appointment whether they want to keep the visit strictly as a wellness visit or also address other concerns.

What Is the Difference Between a Wellness Visit and a Regular Doctor Appointment

This is one of the most common points of confusion in Medicare. The difference matters because it affects what is covered and what you may owe.

The simplest way to understand the distinction: a wellness visit looks forward (what can we prevent?), while a regular office visit looks at what is happening now (what do we treat?).

Patients with chronic conditions such as diabetes or hypertension often benefit from scheduling both types of visits. The AWV establishes a prevention roadmap, while separate chronic disease management visits handle ongoing treatment. At All In One Care Solutions, our primary care services in Miami Gardens are structured to support both types of care efficiently.

What Happens During a Medicare Annual Wellness Visit

The structure of an AWV follows a consistent clinical framework, though the conversation will be personalized to your health history.

A typical visit proceeds as follows:

1. Health risk assessment questionnaire – Completed before or at the start of the appointment, covering your medical history, family history, medications, and lifestyle habits.
2. Review of vital measurements – Blood pressure, weight, BMI, and height are recorded and compared to previous values.
3. Medication reconciliation – Your provider reviews all current medications, including over-the-counter drugs and supplements, to check for interactions or concerns.
4. Cognitive and mental health screening – Brief standardized tools are used to screen for memory issues and depression.
5. Fall risk assessment – Particularly important for patients 65 and older, this evaluates balance, gait, and home safety factors.
6. Discussion of preventive services – Your provider will recommend screenings and immunizations appropriate for your age, sex, and health history.
7. Personalized prevention plan – A written summary is created outlining your health goals and recommended next steps for the coming year.

For patients managing conditions like high blood pressure or diabetes, this visit is a good time to confirm that your chronic disease management plan is on track. Learn more about blood pressure care in Miami Gardens and diabetes care in Miami Gardens as complementary services.

Do You Need to Schedule Your Medicare Wellness Visit in Advance

Yes. Medicare wellness visits are scheduled appointments, not walk-in services. Calling ahead allows the clinic to allocate sufficient time (typically 30 to 45 minutes) and prepare your health records.

When scheduling, specifically request an “Annual Wellness Visit” or “AWV” so the appointment is coded correctly. Using that exact language helps the front desk team ensure the visit is billed as a preventive service, which protects your $0 cost-sharing benefit.

At All In One Care Solutions, patients can schedule a primary care appointment in Miami Gardens by calling (786) 446-9414 or booking online. Same-day appointments may be available for other services, but the AWV is best planned in advance.

Can You Get a Wellness Visit If You Are on Medicare Advantage

Yes. Medicare Advantage (Part C) plans are required by law to cover all Medicare Part B preventive benefits, including the Annual Wellness Visit at no cost to the patient.

In fact, many Medicare Advantage plans offer enhanced wellness benefits beyond Original Medicare, such as additional screenings, dental or vision check-ins, or transportation to appointments. The specific benefits vary by plan, so patients should review their Evidence of Coverage document or call their plan’s member services line.

Common mistake: Some Medicare Advantage enrollees assume their plan works differently from Original Medicare and skip the wellness visit. The AWV is a protected benefit under all Medicare Advantage plans. Not using it means leaving a covered, no-cost service on the table.

What Should You Bring to Your Medicare Wellness Visit

Coming prepared makes the visit more productive and ensures your prevention plan reflects your actual health situation.

Bring the following:

• Complete medication list – Include all prescription medications, over-the-counter drugs, vitamins, and supplements with dosages.
• Insurance cards – Your Medicare card and any supplemental or Advantage plan cards.
• Photo ID
• Recent lab results or medical records – If you have had blood work, imaging, or specialist visits in the past year, bring copies or request that records be sent ahead.
• List of current providers – Names and contact information for any specialists you see regularly.
• Health concerns or questions – Write them down in advance. Even if they are not addressed during the AWV itself, your provider can schedule a follow-up visit.
• Family health history – Particularly relevant for conditions such as heart disease, diabetes, or certain cancers.

For patients in Miami Gardens, Miami Lakes, or Hialeah who want a comprehensive medical exam alongside their wellness visit, our team can coordinate both services efficiently.

Are Preventive Screenings Included in Wellness Visits

Preventive screenings are recommended during the AWV, but they are not always performed in the same appointment. The wellness visit itself identifies which screenings are appropriate for you. The screenings may then be ordered as separate services.

Medicare Part B covers many preventive screenings at no cost, including:

• Diabetes screening (for at-risk patients)
• Cardiovascular disease risk screening (cholesterol and lipid panels)
• Colorectal cancer screening
• Mammograms (annually for women 40 and older)
• Bone density scans (for women at risk of osteoporosis)
• Depression screening
• Lung cancer screening (for eligible current or former smokers)
• Abdominal aortic aneurysm screening (one-time, for qualifying patients)

The AWV serves as the clinical roadmap that connects you to these screenings. Your provider documents which ones are due and places the appropriate orders. For women seeking preventive screenings, our women’s health clinic in Miami Gardens offers coordinated care that includes both wellness visits and follow-up screenings.

Do You Have to See Your Primary Care Doctor for a Wellness Visit

No. Medicare allows Annual Wellness Visits to be conducted by a range of qualified providers, including:

• Primary care physicians (MD or DO)
• Nurse practitioners (NP)
• Physician assistants (PA)
• Clinical nurse specialists (CNS)
• Certified nurse-midwives

However, seeing your established primary care doctor is generally the best option. A provider who knows your full health history can create a more accurate and useful prevention plan. Continuity of care also makes it easier to track changes year over year.

If you do not yet have a primary care provider in South Florida, establishing care with a family medicine doctor in Miami Gardens before your wellness visit is strongly recommended.

What If Your Doctor Does Not Offer Medicare Wellness Visits

Not all providers bill for Annual Wellness Visits, even if they accept Medicare. Some smaller practices or specialists may not be set up to bill the AWV correctly. In that case, patients have several options:

• Ask your current provider to refer you to a primary care practice that offers AWVs.
• Contact a dedicated primary care clinic in your area that accepts Medicare and specifically offers preventive wellness services.
• Call Medicare directly at 1-800-MEDICARE to find enrolled providers near you.

Can you get a wellness visit at an urgent care clinic? Technically, some urgent care centers that accept Medicare can bill for an AWV, but this is uncommon. Urgent care is designed for acute, same-day concerns. The AWV requires a more structured, relationship-based appointment. A primary care clinic is the appropriate setting for this service.

What Is Included in the Personalized Prevention Plan from a Wellness Visit

The Personalized Prevention Plan (PPP) is a written document created at the end of your AWV. It is one of the most clinically valuable outputs of the visit.

A complete PPP typically includes:

• A summary of your current health status and risk factors
• A list of recommended preventive screenings and their suggested schedule
• Immunization recommendations based on your age and history
• Referrals to specialists or community resources as needed
• Health behavior goals, such as targets for physical activity, nutrition, or smoking cessation
• A follow-up schedule for managing any identified chronic conditions

The PPP is not a static document. Each year, your provider updates it based on new lab results, changes in your health, and whether you completed the prior year’s recommendations. Over time, it becomes a meaningful record of your preventive care trajectory.

Patients managing chronic disease management in Miami, including those with diabetes, hypertension, or high cholesterol, will find the PPP particularly useful for staying organized across multiple providers and treatment goals.

What Happens If You Miss Your Medicare Wellness Visit

Missing your Annual Wellness Visit does not result in a financial penalty or loss of benefits. Your Medicare coverage remains intact. However, there are real health consequences to consider.

• Missed screenings: Without the AWV, recommended screenings may not be ordered on schedule. Early detection of conditions like colorectal cancer, diabetes, or cardiovascular disease depends on consistent preventive care.
• Outdated prevention plan: Your health risks change year to year. An outdated plan may not reflect new medications, new diagnoses, or new risk factors.
• Missed cognitive screening: Cognitive decline is often gradual. Annual screening creates a baseline that makes changes easier to detect.

If you missed your wellness visit this year, you can still schedule one before December 31 to use your calendar-year benefit. Contact a primary care clinic in Miami Gardens to check availability.

Frequently Asked Questions

Q: Is the Annual Wellness Visit the same as an annual physical?
A: No. The AWV focuses on prevention planning and health risk assessment. A traditional annual physical includes a hands-on physical examination and may involve diagnosis or treatment. Medicare covers the AWV at no cost; a routine physical exam is not a covered Medicare benefit under Part B.

Q: Can I have my wellness visit and a sick visit on the same day?
A: Yes, but the sick visit will likely be billed separately and may involve a copay. Inform your provider at the start of the appointment so both services are documented and billed correctly.

Q: Does Medicare pay for lab work done during the wellness visit?
A: Lab work ordered during the AWV is billed separately. Whether it is covered at no cost depends on the type of test and whether it qualifies as a preventive screening under Medicare Part B guidelines.

Q: How do I know if I have already used my Annual Wellness Visit this year?
A: Log in to your Medicare account at Medicare.gov or call 1-800-MEDICARE to review your claims history.

Q: Can a telehealth appointment count as my Annual Wellness Visit?
A: Yes. As of 2026, Medicare continues to allow telehealth delivery of Annual Wellness Visits. The same coverage rules apply.

Q: What if English is not my primary language?
A: You have the right to request an interpreter. Many primary care clinics in South Florida, including All In One Care Solutions, offer bilingual services in English and Spanish to serve the local Hispanic community.

Q: Can my spouse and I schedule our wellness visits on the same day?
A: Yes, as long as each person has a separate appointment. Each Medicare beneficiary has their own individual AWV benefit.

Q: What if I am homebound and cannot travel to a clinic?
A: Some Medicare-enrolled providers offer home visits. Contact your local Medicare office or a care coordinator to explore options for homebound patients.

Q: Will my Medicare Advantage plan cover additional services during the wellness visit?
A: Many Medicare Advantage plans offer enhanced benefits. Review your plan’s Evidence of Coverage or call member services to confirm what is included.

Q: I was just diagnosed with diabetes. Should I still schedule a wellness visit?
A: Yes. A new diagnosis makes the AWV even more important. Your provider can use the visit to establish a baseline, order appropriate screenings, and build a prevention plan that accounts for your new diagnosis. See our diabetes care services in Miami Gardens for additional support.

Conclusion

Medicare Wellness Visits Explained simply: they are one of the most underused benefits in Medicare, and one of the most valuable. A single annual appointment can identify health risks before they become serious conditions, connect you to covered screenings, and give you a written plan for the year ahead, all at no cost to you.

For Medicare patients in Miami Gardens, Miami Lakes, Hialeah, and surrounding South Florida communities, taking advantage of this benefit is a straightforward step toward better long-term health. Patients managing chronic conditions like diabetes, hypertension, or high cholesterol have the most to gain from consistent annual wellness visits paired with ongoing chronic disease management.

Next steps:

• Call All In One Care Solutions at (786) 446-9414 to schedule your Annual Wellness Visit.
• Ask specifically for an “Annual Wellness Visit” when booking to ensure correct billing.
• Bring your medication list, insurance cards, and any recent lab results.
• Use the visit to establish or update your Personalized Prevention Plan for 2026.

All In One Care Solutions is located at 16191 NW 57 Ave, Miami Gardens, FL 33014. The clinic accepts Medicare and most major insurance plans, and offers bilingual services in English and Spanish. Same-day appointments are available for other primary care needs. Visit allinonecaresolutions.com or call (786) 446-9414 to book your appointment today.

References

• Centers for Medicare and Medicaid Services. “Medicare Preventive Services: Annual Wellness Visit.” CMS.gov. 2023. https://www.cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services
• U.S. Department of Health and Human Services. “Your Medicare Coverage: Wellness Visits.” Medicare.gov. 2024. https://www.medicare.gov/coverage/wellness-visits
• American Academy of Family Physicians. “Medicare Annual Wellness Visit.” AAFP.org. 2022. https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/medicare-annual-wellness-visit.html

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