Are you taking advantage of Medicare’s free Annual Wellness Visit (AWV)? The AWV allows you and your provider to focus on key areas for staying well: disease prevention and detection and health promotion.

If you’re new to the AWV, you may have questions about what it includes and how we can further meet your needs.

What does the Annual Wellness Visit include?

“An AWV is a tool clinicians use to assess a patient’s overall health,” says Summit Health Vice-Chair of Primary Care in New Jersey, Jill Hup, MD. “It is meant to measure how well a patient can perform their daily activities and help keep them up to date with preventative screenings and vaccinations.”

Your AWV may include:

• A review of your medical, surgical, and family history
• Measurements of your height, weight, and blood pressure
• Assessments for depression, fall risk, and memory problems
• A review of your prescriptions and over-the-counter drugs for possible interactions
• Recommendations for immunizations, such as the flu or pneumonia shots, and health screenings for cancer, such as colonoscopy or mammogram
• A written preventive plan that outlines next steps for continued wellness
• Advance care planning as appropriate

Medicare covers one AWV a year, so schedule accordingly. For example, if you schedule an AWV in May of this year, the soonest you can come in for your next one would be May of next year.

Doesn’t my provider review my medical history, measurements, and prescriptions during my other visits?

Yes, your provider reviews this information at every visit; however, the AWV goes further.

The AWV allows time to assess your overall health and wellness holistically. This means that in addition to regularly reviewed information, your provider works with you to develop a wellness plan inclusive of all your screenings, immunizations, risk factors, personal history, and other preventive recommendations.

The reason that Medicare recommends the AWV is because it has been proven to keep patients healthy. Patients within our group who have AWVs every year complete more of their recommended screenings. They also have better control of their chronic conditions and fewer subsequent illnesses.

Does the AWV include a physical exam?

While the AWV is a valuable component of preventive care, it does not include a physical exam or address active medical problems. “We know this general view of wellness does not tell the whole story,” notes Dr. Hup. “Many of our patients live with chronic medical conditions like hypertension, diabetes, obesity, and depression that require close monitoring. Therefore, we offer a Comprehensive Care Visit (CCV) to ensure all medical issues are addressed at the time of the AWV. We want to educate patients about their disease, recommend treatment strategies to get their condition under good control, and provide encouragement and guidance along the way to enable them to live their very best life,” she adds.

A CCV includes all the AWV’s preventive services plus:

• A physical exam
• Management of acute and/or chronic conditions, including back pain, allergies, difficulty sleeping, mental health concerns, diabetes, high blood pressure, arthritis, or heart palpitations
• Referrals for laboratory or imaging tests as needed
• Follow-up with a specialty physician if required

Incorporating a CCV into your health care is a good idea, even if you’ve had a physical exam in the past.

“In primary care throughout Westmed Medical Group and Summit Health, we believe in providing comprehensive, lifelong care for patients,” says Nicholas L. Pantaleo, MD, Chief of Internal Medicine at Westmed Medical Group, a Summit Health Company. “Therefore, if you are having any additional issues such as joint pain or are in need of blood pressure monitoring—even though this is not covered with the AWV—our providers will gladly address these new or chronic care concerns and even perform a physical exam.”

When you add a CCV to the AWV, you are only responsible for a copayment or coinsurance like any other visit to the doctor. Some Medicare Advantage plans cover a physical exam and the AWV.

I’ve been asked to come in for a blood draw before my AWV or CCV. Will it be covered?

The AWV does not include routine blood tests; however, to save you time and offer more comprehensive care, your provider may combine the AWV with your routine follow-up visit and may request blood tests. Lab tests are covered under your Medicare benefits based on the medical diagnosis associated with the orders. A patient may be responsible for the copayment/coinsurance as with other tests.  

Primary care is essential to better overall health

Primary care providers are the cornerstones of patient care, particularly in adults age 65 and older. Research shows that people who have an ongoing relationship with a primary care provider and get their recommended screenings and immunizations have better overall health and lower mortality rates.

“We strongly believe in caring for the whole person and in addressing all of your health care needs, including acute issues, and chronic conditions,” says internal medicine physician and Chief Quality Officer Ashish Parikh, MD. “Preventive medicine saves lives. “Even if you’re in generally good health for someone over 65, you may not realize that your blood pressure is high, a medication has an interaction, or you are overdue for an eye exam. That’s why we encourage all our Medicare patients to make sure they have their AWV every year, whether they see their providers only once a year or come in often for follow-up visits.” 

If your primary care physician isn’t available when you want to come in for an AWV, another provider can step in to keep you on track. All our providers use a shared medical record system, so your primary care physician will be able to access information after your visit. The provider who covered your visit will communicate any recommendations, as well.

If you do not have a primary care provider, we will find one for you.