Your Guide to Your Annual Wellness Visit

In recent years, health care has been focused on pre­ven­tive med­i­cine. Pre­ven­tive med­i­cine empha­sizes the pro­mo­tion of a healthy lifestyle and proac­tive­ly mon­i­tor­ing for var­i­ous health con­di­tions includ­ing hyper­ten­sion, dia­betes or can­cers. To sup­port these efforts, most com­mer­cial insur­ance providers now cov­er the cost of an annu­al well­ness exam pro­vid­ed by an in-net­work pri­ma­ry care provider*. Pre­ven­tive med­ical care is impor­tant because it pro­vides you and your care team with an oppor­tu­ni­ty to assess your cur­rent health, which can be use­ful for antic­i­pat­ing future health care needs.

Once an in-net­work provider has been select­ed, you can sched­ule your annu­al well­ness exam. A well­ness or pre­ven­tive exam helps your physi­cian mon­i­tor your over­all health, iden­ti­fy ways to keep your body and mind healthy and iden­ti­fy any under­ly­ing issues when they are in their ear­li­est, most treat­able stages.

What to expect at your annu­al well­ness visit

An annu­al well­ness vis­it is dif­fer­ent from a check­up or sick vis­it. Dur­ing the well­ness vis­it, your provider will use screen­ing and assess­ment tools to uncov­er any unknown med­ical con­di­tions. Patients will receive a phys­i­cal exam and par­tic­i­pate in a dis­cus­sion about their gen­er­al well-being, includ­ing their phys­i­cal and emo­tion­al health. Addi­tion­al top­ics you may dis­cuss with your physi­cian include:

• Med­ical, social and fam­i­ly history
• Cur­rent med­ica­tions and aller­gies if applicable
• Health rec­om­men­da­tions includ­ing diet and exercise
• Med­ical coun­sel­ing for any cur­rent health con­di­tions or a pre­ven­tion plan for those you may at a high­er risk of developing
• Immu­niza­tion rec­om­men­da­tions based on age or gender
• Addi­tion­al test­ing rec­om­men­da­tions includ­ing blood work and age or gen­der appro­pri­ate screen­ings that may be due

What is the dif­fer­ence between an annu­al well­ness vis­it and an office or sick visit?

It is impor­tant to under­stand that a well­ness exam is not the same as a sick vis­it. Sick vis­its with your pri­ma­ry care doc­tor are used to eval­u­ate new or exist­ing con­di­tions, pain or symp­toms and can include the man­age­ment of chron­ic health con­cerns. It is pos­si­ble for patients to be sched­uled for both a well­ness and a sick vis­it in one day. It may also occur if a patient dis­cuss­es addi­tion­al con­cerns dur­ing a well­ness vis­it or if a new health prob­lem is diag­nosed or dis­cussed dur­ing the exam. In these instances, patients could be billed for both a sick and a well­ness vis­it. The phys­i­cal exam and screen­ings would be billed as pre­ven­tive, cov­ered ben­e­fit while the por­tion of the vis­it that relates to the treat­ment of the new health issue will be billed as a sick vis­it and applied toward your deductible or coin­sur­ance. If the major­i­ty of the exam is spent treat­ing med­ical con­cerns, the entire vis­it may be con­sid­ered a reg­u­lar office vis­it and not a well­ness exam.

To suc­cess­ful­ly com­plete your annu­al well­ness exam, fol­low the tips below:

• When sched­ul­ing your appoint­ment, use terms like ​“rou­tine pre­ven­tive exam” or ​“annu­al phys­i­cal” rather than request­ing a ​“check-up”, which usu­al­ly indi­cates fol­low up on an exist­ing health problem
• At the begin­ning of your appoint­ment, let your provider know you are there for your annu­al well­ness exam
• If you have a spe­cif­ic, sep­a­rate health prob­lem you want to dis­cuss dur­ing the exam, you may receive a bill after the vis­it for a charge relat­ed to the treat­ment of that problem

Rather than wait­ing to dis­cuss all of your health con­cerns dur­ing an annu­al well­ness exam, use this time to work with your physi­cian on the pre­ven­tion of future health con­di­tions. Cur­rent or chron­ic con­di­tions may require a diag­nos­tic vis­it and var­i­ous appoint­ments to pro­vide treat­ment through­out the year.

Sched­ule your annu­al vis­it with a pri­ma­ry care provider today > 

*To con­firm if a provider is con­sid­ered in-net­work for your plan, you can call the mem­ber ser­vices num­ber list­ed on the back of your insur­ance card, or vis­it your insur­ance com­pa­ny’s web­site and use their physi­cian find­er tool.