The IPPE, otherwise known as the “Welcome to Medicare” visit, is strictly for those patients new to Medicare. This a one-time only exam paid for by Medicare for beneficiaries who have enrolled in the Medicare Part B program within the last 12 months.
Please note, this is not a comprehensive physical exam. The visit includes the following:
It is important to note that, with the exception of this initial exam, Medicare does not cover routine physical exams. After the visit, your provider will provide you with a plan or checklist outlining the screenings and preventative services you should get.
Medicare Part B coverage allows for an Annual Wellness Visit (AWV) one-year after your Initial Preventive Physical Examination (IPPE) and yearly thereafter. At your AWV you and your primary health care provider will update your medical records, determine health concerns based on your medical/family history and perform a simple examination to assess your weight, body mass index and blood pressure.
You are eligible for an “annual wellness visit” 12 months after the date of your “welcome to Medicare” visit. This visit is a strategy session designed to help you and your primary care provider develop an ongoing health plan intended to keep you healthy, safe, and independent for a long time. The AWV includes the following:
An AWV is not a physical examination or a preventive medicine service and does not include medication refills, routine physical checkups or services for new or existing health problems. These services will require an extended visit, which will be billed separately and may not be covered by Medicare.
No. The annual wellness visit is not a physical. An annual physical is a more extensive physical examination. In addition to collecting a medical history, a physical may also include:
You may choose to have a physical at another visit, but Medicare will not pay for this service.
If you have a Medicare Advantage or other type of Medicare replacement plan, you will need to see if the plan pays for an annual physical; otherwise, you will be responsible for payment.
You pay nothing out of pocket for this visit. However, you may be responsible for a deductible or co-pay expense if additional evaluation is required.
You are eligible for the annual wellness visit after you have had Medicare Part B for more than 12 months. However, if you've had a “Welcome to Medicare” visit within the last 12 months, you must wait 12 months from that visit before you can have your annual wellness visit.
You may have an annual wellness visit once every 12 months.
You will see your primary care provider, who could be a physician, nurse practitioner, or physician assistant.
Depending on which clinic you go to, you may also spend time with nursing staff or other medical professionals who will help gather your medical history so that your health care provider can determine an appropriate preventive health screening plan.
To determine when you become eligible for your first Medicare annual wellness visit, call your primary care provider’s office.