Your mom's doctor's office calls to schedule her "wellness visit," and she assumes it's her yearly physical. Then she's surprised when the doctor asks lots of questions, doesn't do a full exam, and suggests a separate appointment for her knee pain. Knowing what this visit is, and isn't, helps your parent get the most from it, and gives you a chance to share what you've been noticing at home.
This guide uses Medicare.gov. Costs depend on your parent's coverage and provider; ask the office before the visit1.
What the Annual Wellness Visit is
The yearly Wellness visit is a conversation-based visit with a doctor or other provider to develop or update a personalized plan to help prevent disease or disability, based on your parent's current health and risk factors1. It isn't a routine physical exam1.
That distinction matters. Medicare says that if your parent has specific health concerns, they should schedule a separate appointment for those, so the Wellness visit stays focused on prevention1. A new symptom, like knee pain or dizziness, may be handled at a separate visit with normal costs. It's a good time to review medicines; see polypharmacy in the elderly.
Who qualifies and how often
Medicare Part B covers the visit once every 12 months1. The first yearly Wellness visit can't take place within 12 months of Part B enrollment or of the "Welcome to Medicare" preventive visit, but your parent doesn't need to have had the Welcome visit to qualify1.
The "Welcome to Medicare" visit is a separate, one-time preventive checkup in the first 12 months of Part B. It reviews medical and social history, preventive services, vaccines, depression risk, and includes a simple vision test and body mass index2. After that first year, the Annual Wellness Visit takes over. Ask whether your parent has had the shingles vaccine; see shingles in the elderly.
What happens during the visit
Your parent will be asked to fill out a questionnaire called a Health Risk Assessment1. Then the provider will1:
- Take routine measurements. Height, weight and blood pressure.
- Review history. Medical and family history.
- Review current prescriptions. A good time to bring every pill bottle.
- Give health advice. Tailored to your parent's risks.
- Offer to talk about advance directives. Legal documents that record wishes about future medical treatment.
- Provide a written plan. A checklist of screenings, vaccines and other preventive services your parent needs.
- Perform a cognitive assessment. To look for signs of dementia, including Alzheimer's disease.
- Evaluate substance use risk. And review pain treatment if your parent uses opioids, including non-opioid options.
- Order other tests if needed. Depending on your parent's health and history.
There's also an optional physical activity and nutrition risk assessment to help the provider understand your parent's activity and eating habits1. Review your parent's shots too; see vaccines for seniors.
The memory check
Every Wellness visit includes a cognitive assessment to look for signs of dementia. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances and making everyday decisions1.
If the provider thinks your parent may have cognitive impairment, Medicare covers a separate visit for a more thorough review, checking for conditions like dementia, depression, anxiety or delirium13. That visit can lead to a care plan. See early signs of dementia and mild cognitive impairment.
Families can help a lot here. Your parent may do fine on a short screening in a quiet office yet struggle at home. If you've noticed missed bills, repeated questions or getting lost, tell the doctor, ideally in writing before the visit.
What it costs
Your parent pays nothing for the Wellness visit if the provider accepts assignment, and the Part B deductible doesn't apply1. But if the provider does additional tests or services during the same visit that aren't part of this preventive benefit, coinsurance and the Part B deductible may apply. If Medicare doesn't cover the extra service at all, like a routine physical exam, your parent may have to pay the full amount1.
Medicare suggests asking the provider what a test or service will cost and why it's recommended1. If you're helping, ask the office when scheduling: "Is this booked as the Annual Wellness Visit only?"
Checklist: what to bring
- A full medicine list. Prescriptions, over-the-counter drugs, vitamins and supplements, with doses. The Welcome visit page recommends the same2.
- A list of all providers. Specialists, therapists, pharmacies and any home health or hospice providers.
- Family health history. Conditions in parents and siblings2.
- Vaccine records. Flu, pneumonia, shingles and others.
- Advance directives. Bring copies if your parent has them, or questions if not.
- Your observations. Changes in memory, mood, sleep, eating, falls, hearing or vision.
- Hearing aids and glasses. So your parent can fully take part in the conversation.
- Top three questions. Write them down so they don't get lost.
Topics worth raising
- Falls and balance. Any fall since the last visit, even without injury. See fall prevention.
- Mood and worry. Medicare also covers a yearly depression screening in primary care4. See anxiety in elderly parents and depression in the elderly.
- Medicine side effects. Dizziness, drowsiness or confusion.
- Advance care planning. Medicare covers voluntary advance care planning, and it can be part of the Wellness visit5. See advance directive vs. living will.
- Driving. If you have concerns. See when should the elderly stop driving.
- Help at home. Whether your parent is managing bathing, meals and medicines.
Wellness visit, Welcome visit and physical compared
- Welcome to Medicare visit. One time, within the first 12 months of Part B. Reviews history and preventive services, checks depression risk, and includes a simple vision test and body mass index2.
- Annual Wellness Visit. Once every 12 months after that. Builds or updates a prevention plan, reviews prescriptions, and includes a Health Risk Assessment and cognitive assessment1.
- Routine physical exam. A hands-on head-to-toe exam. Original Medicare doesn't cover routine physicals, and if one is done during the Wellness visit, your parent may pay the full amount for it1.
Many offices use the word "physical" loosely, which is why surprise bills happen. Ask exactly what is being scheduled.
Tips for scheduling
- Ask for the Annual Wellness Visit by name. So it's booked and billed correctly.
- Check the date of the last one. The visit is covered once every 12 months1, so a visit booked even a few days too early may not be covered as a Wellness visit.
- Book a separate visit for problems. Medicare recommends a separate appointment for specific health concerns1.
- Choose a good time of day. If your parent is sharper in the morning, book a morning slot.
- Ask about forms in advance. Some offices send the Health Risk Assessment ahead so you can help fill it in at home.
If your parent already has dementia
The Wellness visit is still worthwhile for a parent who already has a dementia diagnosis. It's a chance to review medicines, check for falls and other risks, and update the prevention plan1. Medicare also covers a separate cognitive assessment and care planning visit that can help build a care plan, including support for caregivers3. Bring a family member who knows the daily routine, and bring notes, since your parent may not be able to describe recent changes. See stages of dementia care needs.
Common misunderstandings
- "It's my free physical." It's a prevention planning visit, not a physical exam1.
- "Everything done that day is free." Extra tests or services can bring coinsurance or the full cost1.
- "I didn't have the Welcome visit, so I can't get this." You don't need the Welcome visit to qualify1.
- "The memory check means the doctor thinks something is wrong." It's part of every Wellness visit1.
If your parent lives in senior living or rarely leaves home
If your parent lives in assisted living, ask whether a visiting doctor or nurse practitioner can do the Wellness visit on site, and whether staff can help with the Health Risk Assessment. Ask staff to share their own observations about sleep, eating, falls and mood, since they see your parent every day. If your parent rarely leaves home, ask the doctor's office whether a home visit or telehealth option is available, and plan the trip around your parent's best time of day. Either way, request a copy of the written prevention plan for the family file.
How family members can help
With your parent's permission, go to the visit or join by phone. Let your parent speak first; it's their appointment. Offer your observations respectfully, and if there are things you don't want to say in front of your parent, send a note to the office ahead of time or ask the nurse for a moment.
The provider needs your parent's permission to share details with you. A HIPAA authorization or health care power of attorney can help. Afterward, ask for the written prevention plan and put the recommended screenings and vaccines on a calendar. For a mother 65 or older, ask whether a bone density test is due; see osteoporosis in the elderly.
After the visit
Your parent should leave with a written plan, like a checklist, of screenings, vaccines and preventive services they need1. Schedule them right away. If the provider suggested a follow-up memory visit, book it. And if a separate problem came up, make that appointment, too.
If your parent has Medicare Advantage
Medicare Advantage plans must cover the preventive services Original Medicare covers, but networks and scheduling can differ. Check that the provider is in network, and call the plan if you're unsure. See Medigap vs. Medicare Advantage.
An example
Before her dad's Wellness visit, Priya sends the office a short note: he has missed two bills, repeats stories, and fell in the garage in May. At the visit, her dad fills out the Health Risk Assessment, the doctor reviews his seven medicines, and the cognitive screening shows some concerns. The doctor schedules a separate cognitive assessment visit, recommends a balance class and a shingles shot, and offers to talk about advance directives. Priya leaves with the written checklist and books each item that week. This is an illustration; every visit differs.
