Your Medicare Yearly Wellness Visit

Every fall, as my clients and I start looking ahead to the Annual Election Period, I ask the same question: have you had your wellness visit this year? A surprising number of people haven’t. Some don’t know the benefit exists. Others went once, got an unexpected bill, and never went back. Both are a shame, because this is one of the most useful things Medicare pays for — and it’s already part of the coverage you have.

Medicare itself has been reminding people about it this month, and it’s a good moment to explain it plainly: what happens at the visit, what it costs, and how Floridians in Clearwater, Tampa Bay and across the state can get the most out of it.

1. What the Yearly Wellness Visit is (and isn’t)

Medicare calls it the Yearly “Wellness” visit (you’ll also hear “Annual Wellness Visit”). It’s a Part B preventive benefit, and the easiest way to think about it is as a planning meeting about your health rather than an exam. According to Medicare.gov, your doctor or other provider will generally:

• Have you fill out a Health Risk Assessment questionnaire before or during the visit
• Review your medical and family history and your current prescriptions
• Take routine measurements like height, weight and blood pressure
• Do a cognitive assessment to look for early signs of dementia, including Alzheimer’s disease
• Evaluate risk factors for substance use disorder and refer you for treatment if needed
• Offer to talk about advance directives — the legal documents that record your wishes about future medical treatment
• Give you health advice and a written plan (like a checklist) of the screenings, vaccines and other preventive services you’re due for

That written checklist is the real value. It turns “I should probably get that screening someday” into a dated list of what you’re due for, most of which Medicare also covers as preventive care.

2. “Welcome to Medicare” vs. the Yearly Wellness Visit

People mix these two up constantly, and the timing rules matter, because the wrong one at the wrong time may not be covered.

The rule to remember: your first Yearly Wellness Visit can’t take place within 12 months of your Part B enrollment or of your Welcome to Medicare visit. So in your first year, schedule the Welcome visit; from then on, the yearly one. If you’re just turning 65, my turning-65 enrollment timeline walks through the rest of that first year.

3. What it costs — and how to avoid a surprise bill

Here’s the good news straight from Medicare: you pay nothing for the Yearly Wellness Visit if your provider accepts assignment (meaning they accept Medicare’s approved amount as full payment). The Part B deductible — $283 in 2026 — doesn’t apply to the visit itself.

The surprise bills happen when the visit becomes something more. If, during the same appointment, your doctor examines your sore knee, adjusts a medication for a new problem, or orders tests that aren’t part of the preventive benefit, those services can be billed as a regular office visit. Then the Part B deductible and the usual 20% coinsurance may apply to that part. It’s legitimate billing — you did get extra care — but nobody warned you.

A few simple habits keep it clean:

• Use the words when you book. Say you’re scheduling your “Medicare Yearly Wellness Visit,” not a “physical” or a “check-up.”
• Ask before extra tests. If something new comes up, it’s fine to ask, “Is this part of my wellness visit, or will it be billed separately?” Sometimes it makes sense to handle it at a separate appointment.
• Confirm assignment. Ask the office whether the provider accepts Medicare assignment — especially with a new practice.
• On Medicare Advantage? Medicare Advantage plans cover the wellness visit too. Use an in-network provider and check your plan’s Evidence of Coverage for how it handles extra services during the visit.

Routine physicals, by the way, are one of several things people assume Medicare covers when it doesn’t. I walk through the rest in What Medicare Doesn’t Cover in Florida, and the 2026 deductibles and premiums in What Does Medicare Actually Cost in Florida?

4. What to bring

You’ll get far more out of 30 minutes with your doctor if you walk in prepared. Medicare suggests bringing:

• A list of your current medications — prescriptions, over-the-counter drugs, vitamins and supplements, with doses. (Or bring the bottles in a bag.)
• Your health concerns and questions, written down so you don’t forget them in the room.
• Updates about your family health history — a parent’s or sibling’s new diagnosis can change which screenings you need.

I’d add two more: a list of your other doctors and specialists, and a copy of any advance directive you already have (living will, health care surrogate designation), so it ends up in your chart.

5. Three newer Medicare programs to ask about

Medicare has been highlighting three offerings to raise with your doctor at the wellness visit. Each has its own eligibility rules, and whether any of them is right for you is a medical question for your doctor, not me. Here’s what they are, in plain terms.

The Medicare Diabetes Prevention Program

A structured program to help people with prediabetes make lifestyle changes that prevent or delay type 2 diabetes. It’s a Part B preventive service, and you pay nothing if you qualify. It includes 16 weekly sessions over roughly six months, then six monthly follow-up sessions. Sessions can now be taken in person, live online, or self-paced online, and Medicare.gov says there’s no limit to the number of times you can participate.

To qualify you generally need a BMI of 25 or more (23 or more if you’re Asian), a qualifying blood-sugar result within the past 12 months (for example, an A1c between 5.7% and 6.4%), and no prior diagnosis of type 1 or type 2 diabetes or End-Stage Renal Disease. Your wellness visit is a natural time to ask whether your lab results put you in range.

ACCESS — extra support for chronic conditions

ACCESS is a newer Medicare option that offers personalized, technology-supported help managing chronic conditions — Medicare mentions conditions like diabetes, heart disease, depression and chronic pain — often from home, working alongside your doctor. It’s provided by Medicare-approved organizations and is available at low or no cost. Using it doesn’t change your Medicare benefits.

The GLP-1 Bridge

Starting July 1, 2026, a temporary Medicare program called the GLP-1 Bridge lets eligible people get certain GLP-1 medications for weight management for a $50 copayment per month. It works through Medicare drug coverage: standalone Part D plans and Medicare Advantage plans with drug coverage.

• Eligibility is specific. It depends on your BMI and, at lower BMIs, on having certain related conditions. Some people aren’t eligible, including anyone who already gets GLP-1 drugs covered through their Part D plan. Medicare.gov lists the full rules and the covered drugs.
• Your doctor starts it. Your doctor sends the prescription to the pharmacy and completes a prior authorization when asked. Medicare says that prior authorization is valid through December 31, 2027, unless you switch GLP-1 drugs.
• Two catches worth knowing. The $50 copayment doesn’t count toward your drug deductible or your drug out-of-pocket maximum ($2,100 in 2026, $2,400 in 2027), and Extra Help can’t reduce it.

6. Why fall is a good time to go

You can schedule your wellness visit any time you’re eligible, but I like early fall for a practical reason: the Annual Election Period runs October 15 through December 7, and that’s when you can change your Medicare Advantage or Part D coverage for next year. Walking into that window with a fresh medication list, a current list of your doctors, and a sense of what care you’ll need next year makes the coverage review much sharper.

If your prescriptions changed after the visit, a Part D formulary check is the first thing to do. My guide to every Medicare enrollment period covers what you can change and when.

Frequently asked questions

Sources and further reading: Medicare.gov — Yearly “Wellness” visits, Medicare.gov — “Welcome to Medicare” preventive visit, Medicare.gov — Medicare Diabetes Prevention Program, Medicare.gov — ACCESS organizations, Medicare.gov — Weight-loss drugs (GLP-1 Bridge).

This article is for general information only. It is not medical, legal, tax, or personalized insurance advice, and it does not recommend any specific plan, carrier, treatment or medication. Talk with your doctor about which preventive services and programs are right for you. Coverage rules, eligibility requirements and cost-sharing amounts are set federally and can change; the details here reflect Medicare.gov as of September 2026. Always verify current details with Medicare.gov or a licensed agent before making a decision.