
An annual wellness visit with BCBS is a great opportunity to take control of your health. You're eligible for one visit per year, and it's covered under your insurance plan.
During this visit, you'll have the chance to discuss your health goals and concerns with your doctor. This is a great time to ask questions and get personalized advice.
BCBS encourages you to make the most of your annual wellness visit by being prepared. Bring a list of your medications, medical conditions, and any questions you have.
By taking advantage of this visit, you can identify potential health issues early on and develop a plan to stay healthy.
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Annual Blue Medicare Reminder
Blue Cross and Blue Shield of North Carolina reminds providers that the Blue Medicare Advantage program covers one Annual Wellness Visit (AWV) and one Preventive Medicine Visit per calendar year for enrolled beneficiaries.
These visits are a separate benefit from the initial Preventive Physical Exam (IPPE)/ "Welcome To Medicare" visit, available in the first twelve months of enrollment.
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Member's benefits cover one AWV and one Preventive Medicine Visit per calendar year by a licensed health professional.
If providers choose to perform both services together, they are encouraged to follow code issuer guidance with applicable diagnoses and modifiers.
After the first year, benefits include an updated health risk assessment, update of the member's medical and/or family history, measurement of weight, blood pressure, and other routine measurements.
For more information on Annual Wellness Visits and Preventive Physical Exams, please visit the following links:
- Medicare Claims Processing Manual (cms.gov)
- Evidence of Coverage
- Evaluation and Management Services MA
Annual Visits
Blue Cross and Blue Shield of North Carolina covers one Annual Wellness Visit (AWV) and one Preventive Medicine Visit per calendar year for enrolled beneficiaries.
These visits are separate benefits from the initial Preventive Physical Exam, which is available in the first 12 months of enrollment.
The AWV is an opportunity to screen for new problems and manage chronic ones, and it's covered every 12 months for Blue Cross Medicare members.
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During your Annual Wellness Visit, your healthcare provider will ask you to fill out a health risk questionnaire and may also include a review of your medical and family history, Advanced Care Planning, height, weight, blood pressure, and heart rate measurements.
You can expect personalized health advice, a list of risk factors and treatment options, and a screening checklist with preventive services tailored to your specific risks.
If you have any questions or concerns, you can always refer to the Medicare Claims Processing Manual or the Evidence of Coverage for more information.
Here are the covered services for your Annual Wellness Visit:
- Annual Wellness Visit (AWV): G0438/G0439
- Preventive Medicine Visit: 99381-99397
- Initial Preventive Physical Exam (IPPE): G0402
Health and Wellness
As a Blue Cross Blue Shield (BCBS) member, you're eligible for an annual wellness visit to review your health and medications with your provider. This visit can help you stay on top of your health and make changes as necessary.
You can also take advantage of Virtual Care, which allows you to have online visits with your primary care provider. If your provider doesn't offer Virtual Care, they may offer online visits.
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During your annual wellness visit, your provider will ask you to fill out a health risk questionnaire and may also include a review of your medical and family history, Advanced Care Planning, and a screening checklist with preventive services personalized to your specific risks.
Here's a list of questions to ask your provider during your annual wellness visit:
- Do any of my medications need to be changed?
- Does my family history put me at risk for certain conditions?
- What is Advanced Care Planning?
- Would you recommend any additional screenings?
- How can I reduce my risk for falls?
- What questions haven’t I asked?
Achieve Better Health
Achieve better health by taking advantage of your Medicare Advantage plan's benefits. You can review your current health and medications with your provider and make changes as necessary with an annual wellness visit.
Annual wellness visits are a great opportunity to stay on top of your health. As a Medicare Advantage member, you can receive an annual wellness visit every 12 months.
You can also take advantage of virtual care options, such as online visits with your primary care provider. If they don't offer virtual care, they may offer online visits.
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To make managing your prescriptions easier, sign up for automatic refills with Optum Home Delivery. You can do this in your online member account or using the BCBSM mobile app.
Here are some benefits you can expect from your annual wellness visit:
- A review of your medical and family history
- Advanced Care Planning
- Height, weight, blood pressure, and heart rate
- Personalized health advice
- A list of risk factors and treatment options for you
- A screening checklist with preventive services personalized to your specific risks
- Questions about fall risk
Questions for Your Next Wellness Visit
As you prepare for your next annual wellness visit, it's essential to come prepared with a list of questions to ask your healthcare provider. This will ensure you get the most out of your visit and stay on top of your health.
Do any of my medications need to be changed? This is a crucial question to ask, as your medications may need to be adjusted based on your current health status or new medical conditions.
Your family history can play a significant role in determining your risk for certain conditions. Does my family history put me at risk for certain conditions?
Advanced Care Planning is a process that helps you make informed decisions about your end-of-life care. What is Advanced Care Planning?
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Your healthcare provider can recommend additional screenings to help identify potential health issues early on. Would you recommend any additional screenings?
Falls can be a significant concern for older adults, so it's essential to take steps to reduce your risk. How can I reduce my risk for falls?
Finally, don't be afraid to ask questions that may not have occurred to you yet. What questions haven't I asked?
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Programs and Incentives
If you're an FEP Blue Focus member, you can get rewarded for having your routine annual physical. This program is called the Routine Annual Physical Incentive Program.
To qualify, you'll need to visit your primary care doctor for an annual physical. You can find a primary care doctor by downloading the fepblue app or using their National Doctor and Hospital Finder.
The Routine Annual Physical Incentive Program rewards members for having a routine annual physical, a well-woman visit, or both. Well-woman visits screen for breast and cervical cancer.
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To receive your reward, follow these steps:
- Visit your primary care doctor for an annual physical.
- Once they receive the claim from your visit, you'll receive an email and/or a message on your Explanation of Benefits (EOBs) with instructions.
- Follow the instructions and log in to your MyBlue account. If you're a first-time user, you'll need to register.
- Once you're logged in, select your reward and complete the required fields.
Preparing for Your Visit
As you prepare for your annual wellness visit, it's essential to be informed about what to expect. You'll be asked to fill out a health risk questionnaire.
Your healthcare provider will review your medical and family history, which will help them create a personalized prevention plan. This is a great opportunity to share any concerns or questions you may have.
You may also be asked to participate in Advanced Care Planning, which will help your healthcare provider understand your wishes and preferences. This can be a sensitive topic, but it's an important part of your overall care.
During the visit, your healthcare provider will take your height, weight, blood pressure, and heart rate. This will give them a baseline understanding of your current health.
You can expect personalized health advice and a list of risk factors and treatment options for you. This will be based on your individual health needs and circumstances.
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Here's a list of what you can expect during your visit:
- A review of your medical and family history
- Advanced Care Planning
- Height, weight, blood pressure, and heart rate
- Personalized health advice
- A list of risk factors and treatment options for you
- A screening checklist with preventive services personalized to your specific risks
- Expect questions about fall risk
Frequently Asked Questions
What is not included in a wellness visit?
A wellness visit is not for diagnosing new conditions, prescribing new medications, or treating infections, injuries, or discomfort. Schedule a dedicated sick visit if you're experiencing pain or distressing symptoms.
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