Wellness Visit – Sensenbrenner Primary Care
What to Expect at Your Wellness Visit
Your upcoming wellness visit is designed to check in on your overall health, identify risks early, and create a personal plan to help you stay well throughout the year.
During a wellness or preventive/annual visit, your healthcare provider focuses on keeping you healthy.
This page explains what is typically included in a wellness visit, when additional costs may apply, and how we can work together to make the most of your appointment. :contentReference[oaicite:0]{index=0}
What Is a Wellness Visit?
A wellness visit (also called a routine physical or preventive/annual wellness visit) is focused on your overall health and long-term well-being. It is not the same as a sick visit or a visit to manage a specific problem.
During your wellness visit, your provider may:
- Check your height, weight, and vital signs
- Review your medical history and update your records
- Discuss any changes in your health or lifestyle
- Talk with you about health risks based on your age, family history, and current health
- Work with you to create a personal health plan
Wellness visits are an important part of staying healthy and catching potential problems early.
What’s Typically Covered as Preventive Care
Many insurance plans pay for part or all of your wellness care, such as checkups, screenings, and counseling focused on prevention. Coverage varies by plan, so it’s always a good idea to review your benefits.
Often included in a wellness visit:
- Review of medical history and medications
- Routine measurements (height, weight, blood pressure, etc.)
- Discussion of health risks and preventive lifestyle changes
- Age-appropriate screenings and preventive recommendations
- Development of a personal health care plan
May not be covered as preventive care:
- Evaluation and treatment of a new illness or injury
- Focused visits for problems such as infections, joint pain, or abdominal pain
- Management of chronic conditions like diabetes, high blood pressure, or high cholesterol
- Medication changes specifically related to chronic conditions
Important: If your visit includes both preventive care and problem-focused care, your insurance may process this as two types of services, which can lead to out-of-pocket costs such as copays or deductibles.
When Additional Costs May Apply
Depending on your insurance plan, you may owe money out of pocket if, during your wellness visit, you and your provider decide to also address:
- A current sickness or new symptom (for example: an infection, joint problem, or abdominal pain)
- Ongoing management of a chronic illness (for example: diabetes, high blood pressure, or high cholesterol)
- Medication management or adjustments for chronic conditions
In these situations, your insurance company may consider this “problem-focused” or “chronic care” in addition to preventive care, which can result in a copay or deductible.
Your Options During the Visit
- Address both preventive and problem-focused concerns at the same visit (this may lead to out-of-pocket costs depending on your coverage), or
- Schedule a separate visit on another day to address new symptoms or chronic issues.
If you are unsure what your plan covers, please ask your provider or contact your insurance company before your visit.
Questions About Your Coverage?
Every insurance plan is different. For the most accurate information about what is covered during a wellness visit and what may result in additional costs, we encourage you to:
- Call the member services number on the back of your insurance card
- Ask specifically about coverage for “preventive/annual wellness visits” and any limits
- Bring your insurance card and a list of questions to your appointment
If you have questions for our team before your visit, please get in touch with our office, and we will be happy to help.
Frequently Asked Questions
Is my annual wellness visit free?
Many plans cover wellness or preventive visits at little or no cost to you, but this is not guaranteed.
Your responsibility will depend on your specific insurance plan and whether your visit includes additional, non-preventive services.
Can I talk about new symptoms at my wellness visit?
Yes. However, suppose your provider evaluates and treats new symptoms (such as pain, infections, or other concerns). In that case, your insurance may classify that portion of the visit as a problem-focused service, which may result in a copay or deductible.
What if I only want preventive services at this visit?
You can let your provider know that you prefer to focus only on preventive care during your wellness visit.
If you have additional concerns, we can help you schedule a separate appointment to address them.
Why might I receive a bill after a preventive visit?
If both preventive services and problem-focused care are provided at the same appointment, your insurance may apply separate billing codes. This can result in out-of-pocket costs depending on your copays, deductibles, and plan benefits.
Thank you for choosing Sensenbrenner Primary Care for your health care needs.
Wellness visits are an important part of staying healthy, and we look forward to partnering with you to create a personal health plan that supports your long-term well-being.
