Annual Wellness Visit at Home in St. Louis

What an annual wellness visit is

Medicare created the annual wellness visit as a yearly conversation about staying well. The clinician reviews your health risks, updates your records and builds a prevention plan for the year ahead. Some other plans offer something similar under a different name.

For people who find office trips hard, an annual wellness visit at home covers the same ground in a familiar place. A home visit also shows the clinician things an exam room hides, such as stairs, loose rugs, the bathroom layout and how medications are stored.

What the visit includes

The treating clinician decides how the visit runs. It generally includes:

A health questionnaire about daily activities, mood, falls, hearing and safety at home
An update of your medical and family history
A list of your current clinicians, medications and supplements
Basic measurements such as height, weight and blood pressure
A check for signs of memory or thinking problems
A written schedule of the screenings and vaccines that fit your age and health
Advice and referrals for risks that turn up, such as falls or poor nutrition

You may also be offered time to talk about advance care planning, which means your wishes for future medical care. That part is voluntary.

What happens at a home visit

The visit usually runs longer than people expect, because most of it is conversation. The clinician sits down with you, and with a family member if you wish, and works through the questionnaire together. Expect questions about how you manage bathing, dressing, cooking and getting around, how you have been sleeping, and whether you feel safe at home.

Next come the basic measurements and a look at the home itself. The clinician may notice a step with no railing, poor lighting in the hallway, or a stack of pill bottles from different pharmacies. Those observations often turn into practical suggestions, such as a referral for therapy or a review of medications.

The visit ends with a written plan. Ask for a copy, and ask who will follow up on each item.

What it is not

A wellness visit is not a head-to-toe physical, and it usually involves little hands-on examination. It is also not the visit for a new symptom, a medication problem or a wound that needs attention.

If you raise a new problem and the clinician addresses it during the same appointment, that part may be billed as a separate service with its own cost. Ask the practice ahead of time how it handles extra concerns. Our guide to what an annual wellness visit covers goes through this in more detail.

How it connects to wounds and recovery

A wellness visit does not treat a wound, but it looks at many of the things that cause wounds or slow healing. Fall risk, activity, nutrition, continence and tobacco use all come up in the questionnaire or the conversation.

For someone recovering from a wound, the visit is a chance to plan how to keep skin intact afterward. The clinician may suggest skin checks and pressure injury prevention, a closer look at mobility and fall risk, or follow-up on memory concerns that make self-care harder. It is also a natural time to catch up on preventive care and vaccines set aside during a long illness.

Who may visit

Depending on the practice, the plan and what you need, the visiting clinician may be a physician, a nurse practitioner or a nurse working with the treating practice. If you have diabetes or a foot wound, a podiatrist (DPM) can look at your feet as part of your care. The practice decides who is the right person for your visit, and you can ask who is coming when the visit is scheduled.

How it works with your regular doctor

A wellness visit works best when your own physician knows about it. The clinician who does the visit should send the plan and any new concerns to your primary care practice, and the practice should send its records in return. If you have a specialist or a wound care team, ask that they receive a copy too. One shared plan keeps everyone from working on different assumptions.

Getting ready for the visit

A little preparation makes the visit more useful:

Fill out the health questionnaire ahead of time if the practice sends one.
Set out every medication, including over-the-counter products, vitamins and creams.
Write down the names of all your clinicians, including specialists and the wound care team.
Gather the dates of past vaccines and screening tests if you have them.
Note any falls, weight change, memory worries or low mood since last year.

What Gateway arranges

Gateway clinicians can include preventive care in your primary care plan. If you already have a primary care practice, we coordinate with that office to avoid duplicating visits. Medicare has rules about who is eligible and how often the visit can happen, and the treating practice checks those before scheduling.

If you have no primary care clinician, or cannot get to the office, we can help connect you with a partner practice that offers primary care for homebound adults. Availability is confirmed by location and care setting. Benefits depend on your plan and the treating practice, and our insurance page lists questions worth asking first.

Medicare and other plan questions

In general terms, Medicare offers a one-time “Welcome to Medicare” preventive visit during the first year of Part B, and after that an annual wellness visit about once every 12 months. Medicare Advantage and other plans have their own rules and names for similar visits. Rules, timing and any cost to you can differ by plan and can change, so ask your plan and the treating practice before the visit. Gateway does not decide what a plan pays.

Primary care at home near you

Gateway arranges primary care with Gateway clinicians across Greater St. Louis and the Metro East. Availability is confirmed by location and care setting. These pages describe primary care in some of the communities we serve:

You can also read about primary care at home in general.

When not to wait for a wellness visit

A wellness visit is planned in advance, so do not save a concern for it. Contact your clinician now about a new sore, a wound that is getting worse, unexplained weight loss, repeated falls, new confusion or a low mood that does not lift.

Call 911 for chest pain, trouble breathing, signs of a stroke or any other emergency. Gateway is not an emergency service.

How to start

Call 314-325-0126, or send the request care form with a name and phone number only and we will call you. Tell us whether you have a primary care physician and where you live, in Missouri or the Metro East.

Common questions

Is an annual wellness visit the same as a yearly physical?

No. A physical is a hands-on exam, often with lab work. A wellness visit is mostly a conversation and a plan, with a questionnaire, a few measurements and a screening schedule. If you want a physical as well, ask the practice whether it can be done and how your plan handles it.

Will I get a bill for a wellness visit?

That depends on your plan and on what happens during the visit, so ask the practice and your plan beforehand. Costs most often come up when a new problem is evaluated or treated at the same visit, because that work may be billed separately. Gateway cannot tell you what a plan pays.

Does the wellness visit include a memory test?

It includes a check for signs of memory or thinking problems. This may be a few questions, a short screening task, or the clinician’s own observations together with what family members report. It is a screening, not a diagnosis. If something concerning turns up, the clinician will recommend a fuller evaluation.

I have a wound right now. Should I ask for a wellness visit or a regular visit?

Start with the wound. A wound needs assessment by a clinician who can examine it and write orders, and a wellness visit is not designed for that. Once the wound has a plan, a wellness visit is a good way to look at fall risk, nutrition and prevention for the months ahead.

How often can I have an annual wellness visit?

Medicare generally allows one about every 12 months once you are past your first year in Part B, and other plans set their own timing. The practice can check your last visit date and your plan’s rule before scheduling. Bring any paperwork from last year’s visit, since it helps the clinician compare how things have changed.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

An annual wellness visit at home, explained.