Medicare Annual Wellness Visit: What to Expect and How It Differs from a Physical

What Is the Annual Wellness Visit?

The Medicare Annual Wellness Visit (AWV) is a free preventive care appointment available to all Medicare Part B beneficiaries once every 12 months (after your first year on Part B). It is covered at $0 cost — no copay, no coinsurance, no deductible — when performed by a provider who accepts Medicare assignment.

Important distinction: the AWV is not a physical exam. Your doctor will not perform a head-to-toe physical examination, listen to your lungs, or check your reflexes as part of the AWV. It is a health planning and risk assessment visit focused on prevention and early detection.

AWV vs. "Welcome to Medicare" Visit

What Happens During the Visit

Health risk assessment

You complete a questionnaire (often before the visit) covering your medical history, family history, medications, functional abilities, fall risk, mood, and health habits. This information forms the basis of your personalized prevention plan.

Measurements taken

• Height, weight, and BMI calculation
• Blood pressure reading
• Vision screening (if applicable)

Cognitive assessment

Starting in 2026, the AWV includes a structured cognitive assessment — a brief screening for signs of cognitive impairment or early dementia. This is not a diagnosis but a detection tool. If concerns arise, your provider will recommend follow-up testing.

Personalized prevention plan

Based on your health risk assessment, your provider creates a written prevention plan that includes:

• A schedule of recommended screenings (mammogram, colonoscopy, bone density, etc.)
• A list of risk factors and conditions to monitor
• Referrals for preventive services you are due for
• Immunization recommendations
• Advance care planning discussion (covered separately if extended)

Advance care planning

The AWV may include a discussion about advance directives — your wishes regarding end-of-life care, living wills, and healthcare power of attorney. If this discussion extends beyond the AWV, Medicare covers advance care planning as a separate billable service at no additional cost when performed during the AWV.

How to Prepare for Your AWV

• Bring a complete medication list — include all prescriptions, over-the-counter drugs, vitamins, and supplements with dosages
• List your current providers — names and contact information for all doctors and specialists you see
• Note any new symptoms or concerns — the AWV is a good time to flag issues for follow-up
• Complete the health risk assessment questionnaire in advance if your provider sends one
• Bring family medical history — conditions affecting parents, siblings, and children
• Prepare advance care planning questions if you want to discuss end-of-life preferences

Avoiding Surprise Bills

A common complaint: beneficiaries schedule an AWV expecting $0 cost but receive a bill. This happens when the visit goes beyond pure wellness and into diagnostic territory. If you mention a new symptom and the doctor evaluates it, that evaluation is billed as a separate office visit with standard cost-sharing.

To avoid this, clearly communicate that you want the wellness visit only. If a concern arises, ask: "Can we address this at a separate appointment?" or ask the provider to clarify what will be billed as preventive versus diagnostic before proceeding.

Why Scheduling Matters

Only about 50% of Medicare beneficiaries take advantage of the free AWV each year. This is a missed opportunity — the AWV identifies risk factors early, ensures you are current on all recommended screenings, and creates a documented prevention plan. Over time, beneficiaries who attend regular AWVs have better health outcomes and lower total healthcare costs. Schedule yours through your primary care provider or check your state page for finding Medicare-accepting physicians near you.