FAQ

Billing

• Is an "Annual Wellness Visit" the same as a "Physical"?

  No, a Physical Exam is a hands-on head-to-toe examination, while an Annual Wellness Visit (AWV) is a conversation, health risk assessment, and creation of a personalized prevention plan.

  A Medicare AWV includes a health risk assessment, updating your medical/family history, cognitive impairment screening, depression screening, blood pressure check, and creating a screening schedule. An Office Visit is designed to diagnose, treat, or manage a new or existing medical condition or symptom.

• Can I ask about a new pain during a "Wellness Visit" or "Physical"?

  If you bring up a new symptom or a current illness requiring treatment during a wellness visit or physical, the visit may change to an office visit or be an additional office visit charge, which may require a co-pay.
• Are screenings part of a "Wellness Visit" or "Physical"?

  While your provider may discuss the visit creates a plan for screenings (like mammograms or colonoscopies), the tests themselves may be billed separately. Preventative screenings are usually free for Medicare beneficiaries.
• What about labs ordered during my "Physical" exam?

  Labs ordered during a physical exam are not always considered screening. If there is a known condition and the labs are to follow up on that condition, the labs are no longer considered screening and these charges may apply to your deductible.
• Do I have to pay for a "Wellness Visit" or "Physical"?

  If you have Medicare Part B, the initial "Welcome to Medicare" visit (a one-time initial preventative physical exam available within the first 12 months of having Part B) and subsequent annual wellness visits are free (no co-pay or deductible). You will need to check your individual insurance plan for specifics on coverage.