Member: After my annual wellness visit, I received some unexpected charges. Isn’t the visit covered under Medicare? —Margaret, St. Paul
Doctor: Thanks for the question, Margaret. The short answer is yes, your annual wellness visit (AWV) is covered. However, there are some important distinctions to make.
Your AWV is a preventive exam focused on helping you create and manage a healthy lifestyle, including the management of any known conditions. At the visit, your primary care provider will develop a personalized prevention plan after taking routine measurements, providing a health risk assessment, reviewing your ability to safely perform daily activities, addressing your family health history, reviewing medications, and more.
Again, all of this is covered. However, if you are experiencing something new—anything from a rash to dizzy spells or unexpected weight loss—that might alert your doctor to a new condition or health concern. To figure out how to treat or manage something new, your doctor might have to provide additional care that comes with charges.
For example, say you mentioned you were having abdominal pain that seems to get worse after eating. You’ve had irregular bowel movements since the issue developed and you feel moderate pain when touched in the lower abdomen. If your provider orders an X-ray and blood work to determine if inflammation or an infection is present, extra charges would apply.
It’s important to keep in mind that even though additional testing might not fall under your AWV, you should be open with your doctor about any health issues you are experiencing. If you are worried about additional charges, share that concern with your doctor, as there might be more a ffordable ways to evaluate an issue. Remember, prevention and early detection are crucial to your health and wellness!
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