Why am I not being awarded for an Annual Wellness Exam?

Discussion created by go365moderator2 on Aug 15, 2019
Latest reply on Dec 18, 2019 by go365moderator2

When you first enroll in Medicare, you will be eligible for the Welcome to Medicare exam.  In the years following, you’ll have the Yearly Wellness Visit, or Annual Wellness Exam.   Medicare’s website has information on this exam, which you can view here https://www.medicare.gov/coverage/yearly-wellness-visits.


This exam includes the Health Risk Assessment questionnaire, and it can include some activities that are covered with a physical.  Even though you may see your doctor more than once a year, this exam is only done every 12 months (please speak with your Humana Benefits department in regards to any coverage, or out-of-pocket cost questions). Please speak with your doctor about this exam if you are unsure as to if you are receiving a physical or the Annual Wellness Exam.


The Health Risk Assessment is sent back to Medicare, and answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit.


Your doctor visit may also include:

  • A review of your medical and family history.
  • Developing or updating a list of current providers and prescriptions.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of any cognitive impairment.


Please note, your doctor will tell Humana what services they have performed during your visit.  They do this by using a nationally used code(s) that will describe what the visit included. Your doctor will always choose the code they feel best suits your visit. There are specific codes Medicare has allowed Go365 to use for awarding the Annual Wellness Exam, and if your doctor chooses a different code, the exam will not automatically award, and you may need to submit alternate proof. 


All mailed in documents to Go365 must be received by December 15th