Palmetto GBA: A reminder on annual wellness visits for retirees

Published: March 17, 2021

Medicare pays for an Annual Wellness Visit (AWV). It’s an awesome free preventive service that so many Medicare patients have not been taking advantage of. Since the onset of COVID-19, the number of AWVs being performed has fallen drastically, as many people have chosen to put off elective services. However, it’s important for you to do what is best for your health. That also means it may be best to take the time to have this service. If you talk to your healthcare provider and they say that it’s safe for you to have an AWV, then it makes sense to consider doing so.

First off, what is an AWV?

An Annual Wellness Visit is a visit to develop or update a preventive services plan that is personalized to your needs and to perform a Health Risk Assessment (HRA). An AWV comes in two sizes: your initial AWV and your follow-up AWV. Your initial AWV sets the baseline for future visits. Before or during this visit, you will complete a Health Risk Assessment (HRA) questionnaire, which will collect at a minimum:

  1. Your demographic data and a health status self-assessment
  2. Your assessment of depression/life satisfaction, stress, anger, pain, fatigue, isolation or loneliness
  3. Information on behavioral risks, including, but not limited to, if you smoke or use tobacco products, drink alcohol or use drugs, your physical activity and your nutrition
  4. Information on your ability to do general activities of daily living, such as washing clothes, bathing, walking, ability to stand for periods of time, etc.

During an initial AWV, your provider will create a baseline of your medical and family history, capture information about your current list of doctors and medications that you take, and gather measurements of your height, weight, blood pressure and other routine measurements as they apply based on your medical and family history. Your provider may also perform a cognitive impairment assessment to check for Alzheimer’s disease or dementia, and for depression and other mood disorders.

Your healthcare provider will review all of the information you provided to them, along with what they have observed focusing on your ability to do general activities of daily living, your risk of falling, plus any hearing impairments or potential home safety issues that may come up during the visit.

From all of this, your provider will create a written schedule/checklist, for the next five to 10 years for future screening visits and preventive services. Your provider will also give you personalized referrals for health education, preventive programs or counseling services based on what the AWV data has shown them.

These recommended services or programs can help you reduce risk factors or promote wellness, such as increasing weight loss and physical activity, as well as preventing falls and improving your nutrition. Referrals can be made for programs to help you quit smoking. You can also work with your provider to produce Advanced Care Planning documents such as living wills, advanced directives and other documents that instruct others about your healthcare wishes in the event you are unable to do so due to injury or illness.

That’s the first AWV. The second type of AWV is considered a follow-up AWV, or just a plain AWV.

At this AWV visit, you will review and update your HRA and your provider will update your medical/family history, the list of your current providers and medications and your measurements – including weight and blood pressure. Your provider will then make any needed changes to your screening schedule and your personalized health plan, and make new referrals, if necessary, to keep current with your needs. It is important to have this service every year. Your body is constantly changing – every day, every week, every month, every year. You take care of your plants, your car, your family, and you need to remember to take care of yourself as well.

How often can you get an AWV?

You can receive an AWV if:

  • It has been more than 12 months since the effective date of your first Medicare Part B coverage period, and
  • You have not received an Initial Preventive Physical Examination (IPPE, or “Welcome to Medicare” exam ) or an AWV within the past 12 months.

Where can I get an AWV?

Many healthcare providers are authorized to perform AWV services. They include:

  • Doctors of Medicine (MD) or Osteopathy (MO)
  • Physician’s assistant (PA), nurse practitioner (NP), or clinical nurse specialist (CNS)
  • A medical professional (including a health educator, registered dietitian, nutrition professional or other licensed practitioners) or a team of medical professionals working under the direct supervision of a physician.
  • Teaching physicians in graduate medical education programs can perform these services in certain specific circumstances.

If you have a question about the AWV, please call Palmetto GBA’s toll-free Beneficiary Contact Center at 800-833-4455, from 8:30 a.m. until 7 p.m. ET Monday through Friday. They offer a TTY/TDD line at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours as customer service representatives are available. Palmetto’s website is www.PalmettoGBA.com/RR/Me, and offers access to a free self-service internet portal, MyRRMed. MyRRMed offers you access to your healthcare data.

At this time, you can use the portal to access:

  • Status and details of your Railroad Medicare Part B claims;
  • Historical Medicare Summary Notices (MSNs) for your Railroad Medicare Part B claims;
  • A listing of individuals you have authorized to have access to your private health information; and
  • You can also submit a request to add an authorized representative or to edit or remove an existing authorized representative.

To sign up for MyRRMed, visit www.PalmettoGBA.com/MyRRMed.