An annual wellness visit (AWV) is a yearly preventive care appointment covered by Medicare Part B, designed to create or update a personalized plan for keeping you healthy. It costs you nothing out of pocket as long as your provider accepts Medicare assignment. Unlike what many people expect, it is not a head-to-toe physical exam. It’s a structured conversation focused on your health risks, your ability to function independently, and which screenings and vaccines you need in the coming years.
What Actually Happens During the Visit
The centerpiece of every annual wellness visit is a health risk assessment. You’ll answer questions or fill out a questionnaire covering several areas of your life: your mood and emotional well-being (including depression, stress, loneliness, and fatigue), behavioral habits like tobacco use, physical activity, nutrition, alcohol consumption, and even seatbelt use and home safety. Your provider also evaluates how well you manage daily tasks like dressing, bathing, grooming, cooking, managing medications, handling finances, and getting around.
Beyond the questionnaire, the visit includes a review of your medical and family history. Your provider will document past surgeries, hospitalizations, allergies, and any medications or supplements you take. They’ll also note health conditions in your parents, siblings, and children that could raise your risk for hereditary diseases.
A cognitive screening is a required part of the first AWV. Your provider may simply observe you during the visit and ask questions, or they may use a short structured test. The Alzheimer’s Association recommends tools like the Mini-Cog or GPCOG for patients, with separate informant-based assessments (filled out by a family member or caregiver) if there are concerns. No single test is considered definitive on its own, so a low score typically leads to further evaluation rather than an immediate diagnosis.
Your provider will also assess your fall risk, check for hearing problems, and review your safety at home and in the community, including your ability to drive safely. All of this information feeds into a personalized prevention plan: essentially a written schedule of the screenings, vaccines, and preventive services recommended for you over the next several years.
How It Differs From a Physical Exam
This is the distinction that catches most people off guard. Medicare explicitly does not cover a routine physical exam, which it defines as an exam performed without any connection to diagnosing or treating a specific illness or symptom. If you receive a routine physical, you pay 100% of the cost out of pocket.
An annual wellness visit, by contrast, is a prevention-planning visit. Your provider is reviewing your risk factors, updating your health history, screening for cognitive and functional decline, and mapping out which preventive services you need. They may check your blood pressure and record your height and weight, but they’re not doing a full hands-on examination of your body systems. If you want a traditional physical on the same day, that portion will likely be billed separately, and you could owe coinsurance or the full cost for it.
Who Can Perform It
Your annual wellness visit doesn’t have to be with a physician. Medicare allows several types of providers to conduct the visit: doctors of medicine or osteopathy, physician assistants, nurse practitioners, and clinical nurse specialists. A team of health professionals, including health educators, registered dietitians, and other licensed practitioners, can also perform the visit as long as they work under the direct supervision of a physician.
Eligibility and Timing
Medicare Part B covers one AWV every 12 months. If you’re new to Medicare, you’re first eligible for a slightly different visit called the Initial Preventive Physical Exam (sometimes called the “Welcome to Medicare” visit), which must happen within your first 12 months of Part B coverage. After that window closes, you become eligible for the annual wellness visit on a yearly basis going forward.
Both the Welcome to Medicare visit and the annual wellness visit are covered at no cost to you. No copay, no coinsurance, and the Part B deductible doesn’t apply.
When You Might Still Get a Bill
The visit itself is free, but costs can creep in if your provider does anything beyond the defined scope of the AWV during the same appointment. If your provider orders lab work, runs diagnostic tests, or addresses a specific health complaint you bring up, those additional services may trigger coinsurance and the Part B deductible. If Medicare doesn’t cover a particular test or service at all, you could owe the full amount.
This is a common source of confusion and unexpected bills. If you walk in for your wellness visit and mention knee pain or ask about a new symptom, your provider may evaluate that concern on the spot. That evaluation is a separate billable service. It doesn’t mean you did anything wrong, but it helps to know ahead of time that bringing up active health issues can shift part of the visit into diagnostic territory.
Advance Care Planning
Your annual wellness visit can also include a conversation about advance care planning, covering topics like living wills, healthcare proxies, and your preferences for end-of-life care. This is an optional part of the visit, not a requirement. When advance care planning is provided by the same provider on the same day as the AWV, Medicare waives the deductible and coinsurance for it, making the conversation free for you. If the AWV itself gets denied (for example, because it hasn’t been 12 months since your last one), the advance care planning portion loses its cost protection and normal cost-sharing applies.
How to Get the Most Out of It
Because the visit revolves around your health history and risk factors rather than a physical exam, preparation makes a real difference. Bring an updated list of every medication, vitamin, and supplement you take. Write down any family health history you may not have shared before, particularly cancer, heart disease, diabetes, or dementia in close relatives. Think through how well you’re managing daily activities and whether you’ve had any falls, balance problems, or memory concerns.
If you want your provider to also address a specific symptom or health complaint, ask at the start of the appointment whether that can be handled separately. That way you’ll understand upfront if additional charges may apply, and you can make an informed choice about whether to address it that day or schedule a follow-up visit.