Dr. Sandra El Hajj - MSc, N-MD, DHSc
According to the World Health Organization, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Thus, the health status and medical needs of every individual would differ according to the many factors affecting their well-being. These needs would also change based on their environment and lifestyle.
Being fit and healthy has to be a priority for every individual, and a wellness checkup has to be on your yearly agenda. You do not need to be sick or suffering from any ailment for this annual event. Some decide on adopting these checkups to improve their aging process, while others want to improve their health in general. Some decide to start improving their health status through wellness visits when they start a family because they feel responsible for other individuals, their kids and begin having the urge to stay as healthy as possible(1).
A wellness checkup is a yearly assessment during which a patient’s overall health is assessed. This type of checkup aims at detecting any warning signs or lifestyle habits that could lead to serious problems in the future. If you miss a wellness visit, you may be allowing some diseases or conditions to cultivate in your system, causing more serious potential damage to your body and leading to more pronounced complications.
A yearly wellness visit is different and more valuable than a regular physical checkup. The wellness assessment of the patient focuses on the person as a whole being instead of looking for a specific current medical condition that needs to be fixed. Such a holistic assessment is made possible as all factors that could possibly affect a person’s health status are assessed by the practitioner.
Opting for an annual wellness visit is doubly beneficial. It helps the insurance company cut down future expenses for possible illnesses, and it is highly beneficial for the patient. Since patients can generally save money on insurance policies with regular wellness checkups, this helps engage patients and encourage them to prioritize their well-being.
During a visit, the primary care practitioner usually spends 20 to 30 minutes to assess a patient. The conversation provides an opportunity for an open exchange of information, where the patient may be given the chance to disclose other problems that require a follow-up, such as mental problems, addiction, risky lifestyle and other issues.
Early screening means early detection, leading to timely intervention and treatment. Since an annual wellness checkup offers a holistic approach, it can prevent the possible development of diseases.
This preventative care also applies to younger patients. Autism in toddlers is one excellent example. Annual wellness checkups also focus on total body wellness, which includes a modified checklist for autism in toddlers(2). This checkup can be incorporated during the assessment. If a child shows symptoms of autism, the primary care physician will then refer them to a specialist for further assessments that can halt possible future complications.
Immunizations provide the best protection against most infectious diseases. Such protection is one of the most valuable types of care your primary care physician can offer. Wellness checkups can help develop a schedule for these shots going forward.
Aside from medical records that are checked during the assessment, many health determinants such as living conditions, lifestyle, medications, allergies, exposures, immunizations and other factors are also evaluated. The presence of these risk factors in your life will initiate an investigation of possible ailments to be expected in the future. As a result, the primary care physician can offer preventive solutions. For example, if you are a tobacco smoker, this habit can lead to the development of respiratory problems, and in the worst-case scenario, it can lead to cancer. Your primary care physician can develop a better plan for you to improve your lifestyle. He or she may even refer you to a specialist that will address your needs to prevent the possible development of related diseases.
It is important to know that a yearly wellness visit is not the same as an annual physical. They both differ in their costs, patient assessment procedures, criteria and purpose. Unlike an annual physical, the annual wellness visit is not a head-to-toe evaluation to address your current medical needs. It is rather a tool that can help evaluate your wellbeing(3).
It is essential to take into consideration some costs of existing plans in the United States. Medicare, for example, covers an annual wellness visit with no co-payment and no patient deductible. However, an additional payment may be required if additional tests or services are performed during your visit that are not covered under the preventive benefits. This coverage is only valid if the services provided during the visit meet specific criteria for information-gathering, assessment and counseling.
By contrast, the cost for an annual physical exam is not covered by Medicare, but rather should be covered by the patient himself/herself. In some instances, these physicals may be covered by some other Medicare Advantage plans, but you would need to qualify for it.
In terms of purpose, an annual physical exam evaluates the patient and determines if there is any current physical problem. This type of examination is done through physical assessment and laboratory diagnostics. On the other hand, an annual wellness visit identifies existing risks that may lead to the development of diseases. It addresses these risks as a means of prevention through the creation of an action plan that is unique to your medical needs.
When it comes to patient assessment procedures, an annual physical exam includes, essentially, everything that an annual wellness visit would cover (4). It checks more extensively to investigate a physical problem and follow up on long-standing health issues. Specific differences in the assessment procedures are listed below.
To prepare for your annual wellness checkup, you must bring any medical records, immunization records and your health or insurance cards. You should also be able to answer any detailed family health history. Bring with you to the appointment any medication you are taking, and have a complete list of medications including vitamins and supplements with dosage and frequency information. Think about any question you may want your primary care physician to answer and write these questions down so you don’t forget any.
The Wellness Visit focuses more on preventive care rather than treatment because it is not simply a physical exam. It’s an intensive one-on-one assessment through physical examination accompanied by a thorough discussion with your PCP to evaluate your health from all aspects including physical, mental and emotional.
The result of the visit is the development of a personal wellness plan that will be uniquely created based on your health factors. The wellness plan considers your medical and family health history, medications, current health issues, existing health risks, potential health-screening schedule, lifestyle change plans, health and wellness goals and immunizations. So, unlike your regular doctor visits, wellness visits are broader and go beyond just treating your sickness by offering preventive strategies to lessen your risks of developing a disease in the future.
Although your annual wellness visit is offered to you free of charge, there are limited specific services that can be provided. According to Medicare, if you need additional services for laboratory tests or medical treatments, you may be asked for copayment, or your coinsurance and deductible can be honored.
Many get worried and anxious when heading to their first wellness visit. They are not sure what to expect and what will be required from them. So, if you are planning your first visit, here is a list of what to expect:
Based on the model of complete holistic wellness, health insurance companies approach health through preventive care that seeks to improve the health status of every individual. Taking this into consideration, Medicare, for example, developed the annual wellness visit benefit, for their qualified members.
Annual Wellness Visit (AWV) is a benefit for Medicare holders aged 65 years or older and who satisfy the inclusion criteria. This benefit began on January 1, 2011, and encourages an annual visit to a health provider. This visit is covered 100 percent by Medicare and does not require any copay from the regular Medicare holder.
The goal of this program was to create and update a personalized prevention plan that may help prevent illness, based on the evaluated current health and risk factors. Eligibility for this AWV requires the individual to be a Medicare Part B holder for over 12 months and to not have received an AWV in the past 12 months. So, it is offered once a year.
If you are a qualified Medicare member that has satisfied the given criteria for this program, you will be assessed by a Life Line Community Healthcare nurse practitioner or primary care practitioner (PCP) to intentionally develop a personalized wellness plan that will be taken on the day of your visit(5).
Through interview and physical assessment, the nurse practitioner will evaluate your current health status and identify existing risk factors that may lead to chronic diseases. At the end of the assessment, you will have a personalized list of all the recommended Medicare preventive screenings you should be sitting for in the coming few years. This list will be personalized for you.
The annual wellness visit covers an intensive procedure to make sure that it addresses your personal medical needs. It includes several elements, such as a step-by-step review of your medical and family history, a review of your functional abilities. Older people will have a fall prevention and home safety assessment, and a written screening of previous immunizations. The visit will also provide a newly developed immunization schedule for the next 5 to 10 years, the measurement of your blood pressure and other biometrics needed to assess current state, screening for depression or cognitive impairment. Finally, personalized advice for health, nutrition, and exercise will be provided(6).
Annual wellness visits must be done yearly to allow the medical team to have a chance to review and develop plans for your better health throughout the year. The “welcome to Medicare” visit happens only once. This benefit is usually honored during your initial enrollment in Medicare and must be utilized within the first 12 months of your Medicare Part B eligibility. This initial visit provides an opportunity for your doctor to assess your health needs and problems as a starting point for care under your new Medicare plan(7).
Annual wellness visits with your primary care physician are an essential habit that can help you stay healthy and well. It helps evaluate your body holistically, adjusting bad habits and choices, preventing many illnesses and putting you on track. Make sure you do not miss a year, otherwise you are letting at a greater risk for illnesses and some health complications. Before the meeting, you need to know what to expect and what to bring with you. These visits are not the same as the regular physicals, so, plan on scheduling them annually.