Annual Wellness Visit or Physical Exam?
Understanding Your Preventative Care Options
Many patients assume that an Annual Wellness Visit and an Annual Physical Exam (Health & Physical) are the same, but they serve different purposes. Understanding the difference can help you make informed decisions about your health and insurance coverage
What Is an Annual Wellness Visit?
An Annual Wellness Visit (AWV) is a discussion-based consultation focused on preventive care, health risk factors, and future care planning.
What Happens During a Wellness Visit?
Review of medical and family history
List of current providers and prescriptions
Routine measurements (height, weight, blood pressure, etc.)
Preventive screening schedule tailored to your health needs
Discussion of risk factors and treatment options
Immunization recommendations based on age and risk
🚨 Important: If a medical condition requires evaluation or treatment during your wellness visit (e.g., skin lesions, fatigue, seasonal allergies, abdominal issues, depression), this will be billed separately as an office visit.
💡 Medicare Coverage:
Medicare Part B covers a "Welcome to Medicare" visit in the first 12 months of coverage and one wellness visit per year after that.
Most commercial insurance plans cover wellness visits at 100%, but coverage varies.
What Is an Annual Physical Exam?
An Annual Physical Exam (Preventative Visit) is a hands-on examination by your doctor to check your overall health and identify potential issues.
What Happens During a Physical Exam?
Vital signs check (heart rate, blood pressure, temperature)
Lung exam (listening to breathing)
Head and neck exam (checking throat, lymph nodes, thyroid)
Abdominal exam (checking for pain, tenderness, or organ abnormalities)
Neurological exam (reflexes, coordination, and nerve function)
Dermatological exam (skin check)
Extremities exam (joint health, swelling, circulation)
💡 Medicare Coverage:
Medicare Part B does NOT cover an annual physical exam.
Commercial insurance coverage varies by plan.
Which One Do You Need?
If you’re on Medicare, your Annual Wellness Visit is a great way to stay proactive about your health and ensure you’re up to date on preventive screenings.
If you have new or existing health concerns, or want a full physical evaluation, an Annual Physical Exam may be a better choice.
💡 Not sure which appointment is right for you?
The Kazdan Team can help guide you based on your health history and insurance coverage.
Disclaimer: This document is for informational purposes only and is not an all-inclusive list. It is the responsibility of the patient to know what benefits are covered.
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