Does Kaiser Permanente Medicare Cover an Annual Wellness Visit?

In this article...
  • Kaiser Permanente Medicare Advantage plans cover your annual wellness visit in the same way that it’s covered by Original Medicare (Parts A and B). Learn more about the annual Medicare wellness visit and how you can take advantage of it.

Kaiser Permanente Medicare Advantage (Medicare Part C) plans cover everything that Original Medicare (Medicare Part A and Part B) covers, including the Medicare annual wellness visit.

In this review, we outline what a Kaiser annual wellness visit includes, how it’s different from a routine physical and why the annual wellness visit is important.

What Is a Kaiser Medicare Annual Wellness Visit?

While the Medicare annual wellness visit that’s covered by Kaiser Medicare plans is similar to a routine physical, it’s important to note that the annual wellness visit is not the same thing as a general routine physical. Your annual wellness visit does not actually include a physical examination or lab work.

The following services are some of the important health steps you can expect as part of your annual wellness visit covered by a Kaiser Medicare plan.

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Routine Measurements 

Measuring your height, weight, blood pressure and vision is the extent of any physical examination included as part of the wellness visit. Keep in mind that you should ask your doctor about also getting a routine physical sometime during the year so that other important physical health assessments are made, such as checking for cancerous lumps.

Review of Your Medical and Family History

Your doctor will review your own medical history and that of your relatives to look for any potential threats to your future health. 

Assessment of Your List of Health Care Providers

It’s helpful for your primary care doctor to know where you prefer to receive care and the providers you have visited before. This can help them better understand your entire health picture.

Review of Your Current and Past Medications

Understanding the medications you are currently taking or have taken in the past can help your doctor better prescribe future medications as well as diet or lifestyle recommendations. 

Cognitive Impairment Assessment

An assessment will be made to look for signs of Alzheimer’s disease and dementia, along with checking for depression and other mood disorders. 

Your doctor will then work with you to develop some personalized health advice, make diet and lifestyle recommendations and bring attention to anything that needs monitoring. Your doctor will put together a list of treatment options for any risk factors you may have and develop a screening schedule for appropriate preventive services. Your doctor may also speak with you about advance care planning. 

How Much Does the Kaiser Medicare Annual Wellness Visit Cost?

Your annual wellness visit is covered 100% by your Kaiser Permanente Medicare Advantage plan. You pay nothing for the appointment if it is performed by a Kaiser-approved doctor at a Kaiser Permanente medical facility. Any deductibles required by your plan do not apply to the Medicare annual wellness visit.

Note: You may incur other out-of-pocket health care costs if you receive any other care during your wellness visit such as additional tests or services not included in the annual wellness visit portion of the appointment. 

What Is the Welcome to Medicare Visit?

When you first enroll in Medicare, you will become eligible for a “Welcome to Medicare” visit. This visit is used to establish a baseline of your health so your doctor can compare your progress and health changes with each subsequent annual wellness visit.

The annual wellness visit serves as a yearly follow-up appointment where your list of providers and medications is updated and any changes in your health since your previous visit are noted. 

How Should I Prepare for My Annual Wellness Visit?

Here are some tips to help you get the most out of your annual wellness visit. 

  1. Make sure to call it a “Medicare annual wellness visit” (or “Welcome to Medicare visit” when applicable). That way you can ensure the appointment will be administered and billed correctly and that it won’t be billed as a standard physical exam.

  2. You may be able to obtain your health risk assessment questionnaire prior to your visit, which can provide you with ample time to complete it thoroughly and accurately.

  3. A friend or family member may accompany you to the visit to take notes, ask questions you may not think of or help you remember what the doctor says.

  4. Bring any medications or vitamins with you so your doctor can see the brand and dosage levels.

  5. Follow up on any advice your doctor recommends concerning preventive care, vaccinations or changes to your diet, exercise or sleeping routine. 

How Do I Find a Kaiser Plan That Covers the Annual Wellness Visit?

Every Medicare Advantage plan sold by Kaiser Permanente covers the annual wellness visit (and the Welcome to Medicare visit) in full. These visits are covered by Medicare Part B, and Medicare Advantage plans are required by law to cover everything included under Medicare Part A and Part B. 

Kaiser sells Medicare Advantage plans in the following states:

  • California
  • Colorado
  • Georgia
  • Hawaii
  • Maryland
  • Oregon
  • Virginia
  • Washington
  • Washington D.C. 

Helpadvisor.com is owned and operated by Tranzact, the parent company of TZ Insurance Solutions LLC, which is the owner/operator of MedicareAdvantage.com and other websites mentioned on HelpAdvisor and which has a financial relationship with some of the carriers listed on HelpAdvisor.

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