Senior Wellness or Annual Wellness visits allow for a conversation between you and your doctor to discuss your health history and any concerns you may have regarding your health and to review your medications and immunizations. It also is a time when you and your doctor review your existing health problems; determine what health issues may become a concern in the future and how to prevent them.
The goals of these visits are to create a complete personal and family health history and to help prevent future health problems. Potential benefits of annual senior wellness visits include:
- Enhancement of patient activation and engagement with their primary care providers
- Identification of health risks, such as depression; behavioral counseling, such as dietary counseling
- Preventive care services, such as vaccinations or cancer screenings.
SENIOR WELLNESS COVERAGE
Medicare Covers Visit
Initial Preventive Physical Examination (IPPE)
- Review of medical and social health history, and preventive services education
- Covered only once, within 12 months of Part B enrollment
- Patient pays nothing (if provider accepts assignment)
Annual Wellness Visit (AWV) Visit
- To develop or update a personalized prevention plan, and perform a health risk assessment
- The wellness visit can be done by your physician or another member of the healthcare team such as a Physician’s Assistant or Nurse Practitioner.
- Covered once every 12 months
- Patient pays nothing (if provider accepts assignment)
Item that will need to be completed during visit:
- Wellness Form
*The wellness exam only covers the topics detailed above. Additional charges may occur if other issues are addressed during a Patients wellness visit.
Virtual Visits for Well and Sick Visits
Well vs Sick Visits
Sick Visit
An office visit for an acute problem, flare up of a chronic problem or visit for follow up of chronic problems (Diabetes, cholesterol, blood pressure etc.)
Well Visit
An office visit for a routine physical exam or yearly health maintenance exam.
Well/Sick Visit
A combination visit of a routine physical exam in which a chronic issue is addressed. For example, you present today for a well visit and you have an acute or chronic issue you would like addressed, this is considered a combination visit and will be billed differently than just a well visit or just a sick visit.
Why is Billing Different?
The office visit is billed differently to account for the additional time, expertise, and documentation required for a combination visit.
How this Affects YOU
Although many insurance companies acknowledge the sick/well visit combination, some of them require two co-pays or have additional cost applied to your annual deductible. Please contact your insurance carrier to determine how your insurance will cover a sick visit, a well visit and a combination visit.