Medicare Annual Wellness Visit vs. Physical: What Boca Raton Patients Should Know
Many people with Medicare are surprised to learn that the "annual wellness visit" is not the same as a traditional head-to-toe physical. Both can be valuable, but they serve different purposes and are covered differently. Here is a plain-language explanation from South Florida Heart and Vascular Institute (SFHVI), the Boca Raton primary care and heart health practice of Bruce Wishnov, DO.
What the annual wellness visit is
The Medicare annual wellness visit (AWV) is a preventive planning visit covered under Medicare Part B. Its purpose is to create or update a personalized prevention plan. Medicare covers the AWV once every 12 months, and you generally pay nothing for it if your provider accepts Medicare assignment. People in their first 12 months of Part B can instead receive the "Welcome to Medicare" preventive visit.
A typical AWV includes:
- A review of your medical and family history
- An updated list of your current providers and prescriptions
- Height, weight, blood pressure and other routine measurements
- A health risk assessment questionnaire
- A review of cognitive function and screening for depression
- A personalized schedule of recommended screenings and vaccines for the coming years
- An opportunity to discuss advance care planning, if you wish
What a routine physical is
A routine physical exam is a more hands-on examination, and it may include additional lab tests. Original Medicare generally does not cover routine physicals, although some Medicare Advantage plans do. If you also want to discuss a new problem or manage an existing condition during the AWV, that part of the visit may be billed separately and may be subject to copays or deductibles. Our staff can help you understand what to expect before your appointment.
Why the AWV matters for heart health
Cardiovascular risk factors such as high blood pressure, high cholesterol and diabetes often cause no symptoms. The AWV is a structured moment each year to check where you stand, confirm you are up to date on screenings, and review medications. For patients with existing heart conditions, it is also a good time to make sure your primary care and cardiology plans are aligned.
At SFHVI, primary care and heart health are coordinated in one practice. If your wellness visit raises a concern, such as an irregular pulse or rising blood pressure, the next step can happen without starting over at a new office. Learn more about our primary care in Boca Raton and cardiology in Boca Raton.
How to prepare
- Bring your Medicare card, any supplemental or Medicare Advantage cards, and a photo ID.
- Bring all your medications, or an accurate list with doses, including vitamins and supplements.
- Make a list of the other doctors you see, with phone numbers if possible.
- Note your vaccination history, if you have records.
- Write down questions or concerns you want to raise.
- If you have an advance directive or living will, bring a copy.
Chronic care support
Patients living with two or more chronic conditions, such as hypertension and diabetes, may be eligible for Chronic Care Management, a Medicare program that provides ongoing support between visits. Ask our team whether it applies to you. You can find a summary of what we offer on our services page.
Part of a larger network
SFHVI is part of the Advanced Health Cardiology network and the broader Advanced Health Associates group, which connects patients with cardiology, imaging and specialty services across Florida when they are needed.
Schedule your visit
South Florida Heart and Vascular Institute / Bruce Wishnov, DO, PA, 22065 State Road 7, Boca Raton, FL 33428. Call 561-488-4847 or request an appointment.
Frequently asked questions
Is the annual wellness visit free?
Medicare Part B generally covers the AWV once every 12 months at no cost to you if your provider accepts assignment. Additional services during the same visit may have costs.
Do I need a cardiologist referral from my wellness visit?
Only if your clinician finds a reason for one. The AWV is a planning visit; any concerns are followed up as needed.
Coverage details can change. For questions about your Medicare benefits, call 1-800-MEDICARE (1-800-633-4227). This article is general information, not medical or insurance advice.
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