Preventive Care Visits and Problem Visits

Annual Wellness Visit

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. Regular checkups with your physician will help you stay healthy. That’s why most health insurance plans pay for yearly checkups. At your yearly checkup, you and your physician will work together to create a personalized plan to keep you healthy.

Combination Checkup and Problem Visits

You might choose to talk about a new or existing health problem at your annual checkup so that you don’t have to make another appointment. Even though it’s one appointment, by law, Northwestern Medicine must bill for your yearly checkup and your health problem visit separately. When this happens, you may have to pay for the visit differently, depending on your insurance coverage.

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

Preventive visit

Preventive visits can also be called annual checkups or wellness visits.

At your preventive visit, we can:

  • Review your medical history
  • Talk about factors that affect your health
  • Measure your height, weight and blood pressure
  • Set a schedule for common tests like cancer screenings
  • Review your medication list
  • Give you vaccines you need to stay healthy
  • Talk about any questions you have about your long-term health journey

Insurance coverage

Yearly preventive visits are covered by many health insurance plans. You may have no out-of-pocket costs.

Problem visit

At a problem visit, you discuss a new health problem, like an illness, injury or symptom. Examples are a worrisome cough or new pain.

Problem visits include:

  • Talking about and getting treatment for a new health problem
  • Getting treatment for any ongoing health conditions, like high blood pressure, diabetes or high cholesterol

Insurance coverage

Your health insurance will treat each problem visit as a single office visit with a charge. You may need to pay for all or some of the cost.

Combination visit

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

Insurance coverage

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

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?

Download the Preventive Care Visits vs. Problem Visits infographic.