Annual wellness exam checklist

The label on the appointment decides what happens in the room and what it can cost, so call the office and confirm which one you have. Medicare covers the yearly Wellness visit once every 12 months, and your first one can't take place within 12 months of your Part B enrollment or your Welcome to Medicare preventive visit.

• Medicare yearly Wellness visit. A conversation-based visit to create a prevention plan, which Medicare says isn't a routine physical exam. Ask whether this is your first one or a later one, and what forms to complete first.
• Welcome to Medicare preventive visit. A one-time preventive checkup, available once within the first 12 months you have Part B. Medicare says this visit isn't a comprehensive physical exam.
• Routine physical or preventive exam. Ask what the visit includes, whether labs are planned, and what your plan covers.
• Problem-focused visit. Medicare says to schedule a separate appointment for specific health concerns, so the Wellness visit stays focused on prevention.

You pay nothing for the Wellness visit if your provider accepts assignment, and the Part B deductible doesn't apply to it. Coinsurance and the deductible can apply when the provider performs additional tests or services during the same visit that Medicare doesn't cover under the preventive benefit, and Medicare names a routine physical exam as one of those.

Some of this has to happen days ahead, so run through it the week before.

• Confirm the date, time, location, and whether the visit is in person or by telehealth.
• Complete any health risk assessment or pre-visit questionnaire the office sends. For a Medicare Wellness visit that assessment can be filled out before or during the visit (CMS).
• Ask whether to bring records, arrive early, fast, or have labs drawn first. Don't fast unless the care team tells you to.
• Ask the office and your plan about cost if that's a worry.
• Request an interpreter or another communication accommodation ahead of time, because the office may need to arrange it (NIA).
• Bring your insurance card and identification if the office asks for them.
• Bring your glasses, and wear your hearing aid and make sure it's working (NIA).

CMS says the health risk assessment collects, at a minimum, demographic data, your own assessment of your health status, psychosocial risks such as depression, stress, pain, fatigue, and loneliness or social isolation, behavioral risks such as tobacco use, physical activity, nutrition, alcohol, seat belt use, and home safety, and how you're managing daily activities from dressing and bathing to shopping, transportation, medications, and finances.

One accurate list saves the longest part of the appointment. AHRQ tells patients to bring every medicine they take, including prescription medicines, non-prescription medicines such as aspirin or antacids, vitamins, and dietary or herbal supplements. CMS asks Medicare patients to bring the full list along with how often they take each one and how much.

• The name, the dose, how often you take it, and what it's for.
• Allergies, and any previous reaction to a medicine.
• Anything you started, stopped, skipped, or changed since the last visit.
• Side effects, cost problems, or trouble keeping to the schedule. AHRQ says to tell the doctor when you're worried about being able to follow the instructions.

If a written list is hard to put together, ask whether to bring the labeled containers instead. The NIA says some doctors suggest putting everything in a bag and bringing it, while others prefer a list with the doses. Don't stop a prescribed medicine because it looks out of date in a portal. AHRQ says to talk with your doctor or pharmacist before stopping anything you were prescribed.

Care that happened somewhere else is the part your chart is most likely to be missing. CMS asks Medicare patients to bring medical records including immunization records, a detailed family health history, and a full list of the providers and suppliers involved in their care, including behavioral health specialists and community-based services such as personal care, adult day care, and home-delivered meals.

• New diagnoses, procedures, hospital stays, emergency visits, or urgent care visits. The NIA says to tell the doctor right away when you've been treated in the emergency room or by a specialist.
• Vaccines given at a pharmacy or in another health system.
• New allergies or reactions.
• Changes in appetite, weight, sleep, or energy since the last visit (NIA).
• Names and phone numbers of the other doctors you see, and your records if this office doesn't already have them (NIA).
• Home measurements or symptom logs, if the office asked for them.

Mark the pages or the trends you most want the clinician to see.

The visit has a fixed amount of time, and questions saved for the end often don't get asked. The NIA says to put your concerns in order, ask about the most important ones first, and bring up the things really on your mind right away. It suggests picking three or four to name at the beginning. AHRQ's patient sheet asks for the same thing: the top three questions you want to be sure to ask.

Questions about prevention:

• Which screening tests are appropriate for me now, and why?
• Which vaccines should we go through, given my age, my health, my prior doses, my work, and my travel?
• Is anything in my family history changing what you recommend?
• Which of these can happen today, and which need a separate appointment?
• If I wait on a screening or a vaccine, when should we come back to it?
• Could any of this create an additional cost?

Questions about medicines:

• What is each medicine for, and is the list in my chart right?
• Does a new prescription replace something I already take?
• Could it interact with my over-the-counter medicines or supplements?
• What side effects should prompt a call, an urgent visit, or emergency care?
• Who do I contact before changing or stopping it?

Which screenings apply depends on your age, your history, and your other risks, so no general page can hand you the list. The US Preventive Services Task Force publishes the A and B recommendations, the CDC maintains the adult immunization schedule, and MyHealthfinder builds a personalized starting list, and your clinician applies the current guidance to you.

When a test is proposed, AHRQ says to ask how it's done, how it will feel, what you need to do to get ready for it, and how you'll get the results.

Decide the method before you go, because the room is a bad place to work it out. The NIA suggests taking a notepad and writing down the main points, asking the doctor to write them down for you, making notes in the waiting room right after, or bringing an audio recorder and recording what's said with the doctor's permission. It also says a family member or friend can come along, take notes, and help you remember what the doctor said, and that you should tell them in advance what you want from the visit so they don't take too strong a role.

If you want a recording, ask everyone in the room first and accept a no. One way to ask: "I forget the details after appointments. Would everyone be comfortable if I record this for my own notes? It's completely okay to say no." The office can have its own policy on recording, so the working rule is to ask everyone in the room first.

What the visit covers depends on whether it's your first one and on your history. Medicare and CMS say it can include:

• a health risk assessment;
• a review of your medical and family history;
• a review of prescriptions, supplements, and other substances;
• a current list of the providers and suppliers who regularly care for you;
• height, weight, body mass index, and blood pressure;
• a check for cognitive impairment, and a review of depression risk factors;
• a review of how you're managing daily activities, fall risk, hearing, and home and community safety;
• personalized health advice and referrals to services such as fall prevention, nutrition, physical activity, tobacco cessation, and social engagement;
• a written screening schedule for the next 5 to 10 years, built on the US Preventive Services Task Force and ACIP recommendations;
• advance care planning, at your discretion;
• a review of current opioid prescriptions and a screening for substance use disorders; and
• an optional standardized physical activity and nutrition risk assessment.

A Medicare Wellness visit centers on assessment, discussion, and a written prevention plan. It doesn't automatically include a routine physical exam, a lab panel, or every preventive test, so the word exam can mislead you about what to expect.

The visit is only worth what you can act on the next morning, so get the details while you're still in the room.

• Ask for the personalized prevention plan, the visit summary, or the written instructions. Medicare says you get a written plan, like a checklist, telling you which screenings, vaccines, and other preventive services you need.
• Confirm what medication starts, stops, or changes, when, and why.
• Write down each test, vaccine, referral, and follow-up appointment.
• Ask who schedules each one.
• Ask what preparation a test needs and how you'll get the results (AHRQ).
• Ask who to call if a result doesn't arrive when it should.
• Ask what should make you call the office before the next visit. MedlinePlus lists side effects from a medicine or treatment, new unexplained symptoms, symptoms getting worse, and a new prescription from another provider.
• Say the plan back in your own words. The NIA suggests repeating what you think the doctor means and asking whether that's right.
• Check that your portal access and your contact details are current.

Follow-through gets decided the same day, while you still remember the room.

• Open the official instructions: the visit summary, the prevention plan, or the portal message.
• Compare them with your notes. AHRQ says to call the doctor if you don't understand the instructions once you get home.
• Put the medication changes, appointments, tests, referrals, and monitoring on one list.
• Give each item a date and a person who owns it.
• Book what you can book today.
• Note what you're waiting on and when to chase it. AHRQ says to call the office for test results and to ask what you should do about them.
• Call the care team when an instruction is unclear, when symptoms get worse, or when the plan turns out to be hard to follow.

I never decide which screenings you need, and I never choose your questions for you. What I do is text you the morning of the visit with what the office asked you to bring, keep the questions you send me between now and then, read back the prevention plan you photograph, put the tests, referrals, and follow-ups on the calendar, and ask about them until they're done. When one comes due I can pull up the office's number and hours.

No clinician reviewed this page. It restates the Medicare, CMS, AHRQ, National Institute on Aging, and MedlinePlus pages linked below, and those, and the instructions your own office hands you, are the documents to trust over anything here.