Understanding Your Preventive Visit

What is a preventive visit?

A preventive visit is designed to help you stay healthy by focusing on prevention, early detection, and recommended screenings—not treating new or ongoing medical problems.

Depending on your insurance, this may be called:

  • Annual Wellness Visit (AWV)
  • Annual Physical Exam
  • Preventive Visit

During your visit, your provider will review your overall health, update your medical history, review medications, discuss recommended screenings and vaccines, and help you stay on track with your preventive care.

Can I discuss my medical problems during my preventive visit?

Absolutely. Your health concerns are important to us, and we want to hear about them.

However, preventive visits and problem-focused visits are considered different services by most insurance companies.

If your provider evaluates or manages a new or existing medical condition—such as high blood pressure, diabetes, thyroid disease, chronic pain, depression, medication adjustments, or a new symptom—your insurance may require that service to be billed separately from your preventive visit.

Why might I receive a separate charge?

Most insurance plans, including Medicare and many commercial insurance plans, cover preventive services differently than the diagnosis and treatment of medical conditions.

If a significant medical problem is evaluated or managed during your preventive visit, your insurance may process that portion of the visit as a separate office visit. Depending on your plan, you may be responsible for:

  • Copay
  • Coinsurance
  • Deductible
  • Other patient responsibility

These charges are determined by your insurance benefits and billing guidelines—not by our office.

Payment at the Time of Your Visit

If your provider performs a separately billable problem-focused evaluation during your preventive visit, any applicable copay or patient responsibility will be collected at the time of your visit, based on your insurance benefits.

Please note that this payment is an estimate. After your insurance processes the claim, you may receive an additional bill or a refund if your insurance determines your final responsibility is different.

Our Goal Is to Care for You

We never want you to feel that your concerns cannot be addressed. If you have medical issues to discuss, your provider will determine the most appropriate way to care for you while following your insurance company’s billing requirements.

Our goal is to provide comprehensive, high-quality care while helping you understand how your insurance benefits apply to your visit.

Questions?

If you have questions about your preventive care benefits or potential out-of-pocket costs, we encourage you to contact your insurance company before your appointment.

You are also welcome to call our office, and our team will be happy to explain the difference between preventive and problem-focused visits.

AFM Healthcare
(407) 657-2111