I have Medicare Advantage with a PPO, and I'm curious if my annual wellness visit is free or if I'll owe something for it.

Question

Gregg Matheny · Accepted Answer

Your plan more than likely will have a zero dollar co-pay for your annual wellness visit however, it’s always a good idea to double check your summary of benefits to make sure.

Nikki Rowland · Answer

Your annual wellness visits should be covered at no extra cost. Now, if you are seeing a specialist with for this, you will have a specialist Co-pay.

Marie Terhune · Answer

The Medicare Annual Wellness visit does not have a cost or copayment, but it is important to note that the Annual Wellness visit is not the same as an Annual Physical.  The Medicare Annual Wellness visit is a preventative exam.  

A Medicare Annual Wellness Exam is meant to create or update your personalized health plan, it is not a Hands On Exam.  It is typically a series of questions meant to assess your current health status.  It does not include lab work, follow up on chronic conditions, etc.  For that type of an exam (an Annual Physical) you would want to schedule a separate visit with your Primary Care Physician.

Andrew Zurbuch, MBA · Answer

Medicare Advantage covers many preventative care measures. Please check your Evidence Of Coverage document of your Policy or call your Medicare Advantage Insurance Company & request a copy be mailed to you. Further please go to
www.locatemedicareinsurance.com
Thank you.

Andrew J. Zurbuch, MBA
Licensed Broker
Integrated Financial
azurbuch@i-f-s-inc.com

Jon Maves · Answer

Every plan is different so we would need to take a look at your plan to give you a specific answer.  The section we would look at is the Summary of Benefits.

Barbara Margucci · Answer

With most Medicare Advantage Plans, the Annual Wellness Visit is a covered benefit. To be certain, I can review your specific Plan and advise. If you would like more specific information, please contact me for a no-cost, no-obligation Plan Review by calling 412-238-2007

Answered by Barbara Margucci on April 16, 2025

Agent Licensed in PA, OH & WV

Answered by Barbara Margucci Medicare Insurance Agent

Steve Brauer · Answer

Annual Wellness Vists or AWV should be free to anyone with Part B of Medicare. It doesn't matter if you have a PPO or an HMO Medicare Advantage Plan.

Bob Nunn · Answer

Usually there is a list of no charge preventive services in the explanation of benefits and an annual wellness check certain screenings a blood work are customary included. Please look at your policy or call your customer service to verify.

Answered by Bob Nunn on April 12, 2025

Agent Licensed in FL, AL, AR & 36 other states

Answered by Bob Nunn Medicare Insurance Agent

Andre Cabral · Answer

The carriers generally provide the annual House Call at no charge to the member. They send a nurse to check your vitals and medicines. The information they obtain helps the carrier provide better services to members.

Answered by Andre Cabral on April 18, 2025

Agent Licensed in NJ

Answered by Andre Cabral Medicare Insurance Agent

Dominic Javier · Answer

As we know, PPO has in-network and out of network and the latter will cost you more. Annual wellness is usually covered and should be in-plan - free of cost within your PPO network. Check the plan with your PPO if indeed annual wellness is part of the program.

Answered by Dominic Javier on April 22, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Vernon Pate · Answer

My first answer is "always check your statement of benefits provided by your Medicare Advantage provider."

If you've had Medicare Part B for over 12 months, Medicare will cover the cost of an annual wellness visit.  

The Centers for Medicare and Medicaid Services (CMS) has a phone app called "What's Covered. " It is available on the App Store and the Google Play Store.  It contains information about what is covered under Original Medicare Part A and Part B.

I have Medicare Advantage with a PPO, and I'm curious if my annual wellness visit is free or if I'll owe something for it.

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I have Medicare Advantage with a PPO, and I'm curious if my annual wellness visit is free or if I'll owe something for it.

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