Annual Wellness Visits for senior patients ─ and why they are important

Our bright-eyed grandmothers spoke the truth all those years ago when they quipped, “the best things in life are free!”

Medicare and Medicare Advantage encourage all seniors to schedule their Annual Wellness Visit ─ a comprehensive, in-depth conversation with a primary-care physician, which is 100 percent covered by the insurance.

This once-a-year visit, which typically takes an hour or less, is designed to help the doctor develop a personalized preventative healthcare plan for each patient by assessing risk factors and updating important information. That additional data enables healthcare providers to make better-informed decisions toward a goal of maximizing quality of life for each patient.

Different from a ‘physical’

“This is a visit, not an exam, and it’s completely different from what we like to call our ‘physical,’” clarified Dr. Harry Nervino, an internal medicine specialist (retired, but still conducting Wellness Visits for Montage Medical Group). “This is a comprehensive consultation that provides a primary care doctor a clearer understanding of your health concerns and goals from one year to the next.”

The visit (which requires no out-of-pocket payment, no co-insurance, and no co-pay) is mostly a Q&A, during which the doctor reviews a patient’s family health history and personal medical history, including past surgeries, allergies, acute and chronic problems, pain issues, breathing problems, dental status, and other components that might impact your health.

“We’ll also ask about your exercise habits, and whether you need help with things like bathing, grooming, shopping, food preparation, eating, or transportation,” Dr. Nervino said.

“We’ll ask about problems with balance or walking, if you have you fallen recently, need a cane or walker, have a grab-bar in your bathtub and handrails on your stairs, have problems standing up from a sitting position.

“Any issues with vision, hearing, memory, judgment? Are your sleep patterns normal? Are you feeling anxious or depressed?”

A review of meds

The doctor also will review current medications (including homeopathic remedies and over-the-counter meds), some of which might be outdated, or incompatible with other prescriptions.

“Some seniors are managing 10, 15, 20 different prescriptions ─ some from a specialist outside their primary-care record,” said Tyler Munson, CEO of Aspire Health, a provider of Medicare Advantage coverage and population health services. “Often it can be difficult to understand how each medication interacts with others, and whether it might need to be adjusted or discontinued.”

Typically, the only hands-on exams during a wellness visit will include measuring height, weight, and blood pressure.

Tests can be scheduled

Other tests, such as a bone density study for osteoporosis or osteopenia will be scheduled if needed, along with procedures like a colonoscopy (to check for polyps or cancer), abdominal aortic aneurysm ultrasound screening, body-mass index (to detect obesity), mammograms, hepatitis B or C, prostate screening, and a cursory check for glaucoma in the eyes.

Those tests are covered by Medicare or Medicare Advantage plans.

Patients also are queried to see if they are up-to-date with vaccinations and immunizations for Covid, flu, shingles, pneumonia, and tetanus.

Marie Wolf, an administrator of Collaborative Care Services at Montage Medical Group, emphasized that the free Annual Wellness Visit is entirely different from a patient’s yearly physical exam.

“A common misconception is that this is a visit to manage specific medical issues,” Wolf said. “A lot of times, patients think this is a time when they can talk to their doctor about a mole they’ve found, or have an in-depth conversation about their diabetes, or something else.

“When a visit starts addressing specific medical problems ─ new or existing ─ it’s no longer in the category of a preventative visit – it becomes a regular office visit. That can result in a co-pay, or it goes toward their deductible,” she explained. “Our physicians are very good about explaining that a patient might be veering away from the intent of the wellness visit. If patients don’t get that information, and receive a bill a later, it can be upsetting. We certainly want to avoid that.”

Bring medications, vax cards

Patients can save time, and help their physician and medical staff, by bringing all prescription bottles and vaccination/immunization cards to the wellness visit, Dr. Nervino said.

“One additional thing we’ll typically ask is whether an advanced health care directive is in place and if so, does the patient want to make any changes,” said the doctor, referring to a form that advises an emergency room doctor of what the patient wants done in the event that he/she becomes mentally incapacitated and incapable of making a decision.

“If you’re in the emergency room, and you’ve listed things you want done in that kind of situation, it helps the ER doctor,” Dr. Nervino said.

Learn more about annual wellness visits, or contact your Medicare provider, for additional information about Annual Wellness Visits.