Checkups and Medicare Annual Wellness Visits

Your Northwestern Medicine primary care physician is here to support your health and well-being at every age and stage — not just when you are sick.

Insurance Coverage

Most health insurance plans cover annual checkups (often called annual visits, physicals, or preventive or wellness visits) to help keep you healthy.

Medicare may also cover an Annual Wellness Visit once a year. At this visit, you work with your physician to complete a health risk assessment and make a preventive care plan.

Most health insurance plans and Medicare cover the cost of an annual checkup. However, you should check with your insurance company to find out if there is a cost for the visit.

Other medical conditions that you bring up during your visit, such as pain, skin conditions or chronic health issues, will not be covered as part of your annual visit and will be billed.

Questions to ask your insurance company before your visit:

• Is a preventive visit/annual checkup covered by my policy?
• Are preventive screenings like mammograms and colonoscopies covered?
• What are the out-of-pocket costs for lab and imaging tests?
• What vaccines are covered?

If you have questions about your bill, please call 855.694.2866 (TTY: 711).

Annual Checkup

Contact your insurance company to learn what services are covered during a checkup. If your visit is scheduled within a year of your last checkup, please contact your insurance company to confirm it will be covered.

At your annual checkup, your care team may:

• Review or update your medical history
• Check your vital signs
• Do screening tests
• Examine your heart, lungs or other organs

Medicare Annual Wellness Visit

At this visit for patients on Medicare, your care team will:

• Review your medical and family history
• Create or update a list of your physicians and other healthcare professionals and prescriptions
• Measure your height, weight and blood pressure
• Screen for cognitive impairment
• Give you personalized health advice
• Create a list of your risk factors and treatment options
• Set a screening schedule (like a checklist) for preventive care
• Discuss advance care planning

Insurance Coverage for a Combination Visit

You may talk about a specific health condition at your annual checkup. That way you do not have to make 2 separate appointments. This is called a combination visit.

By law, Northwestern Medicine has to bill for your annual checkup and your problem visit separately. When this happens, you may have to pay a co-pay. This depends on your insurance coverage.

Download the Checkups and Medicare Annual Wellness Visits handout.