You’re Probably Not Showing This Preventive Benefit the Way CMS Wants You To

Article by

Admin

July 22, 2025

Key Takeaways

Many independent agents still underemphasize or incorrectly position the Medicare Annual Wellness Visit, which CMS considers foundational to preventive care.
Correctly presenting the visit involves more than just checking a box; it requires aligning your messaging with CMS expectations to build client trust and long-term satisfaction.

You May Be Talking About the Annual Wellness Visit All Wrong

The Annual Wellness Visit (AWV) is one of the most under-leveraged yet highly valued benefits in the Medicare playbook. CMS includes it as a key component in its preventive care strategy—and yet, most agents don’t present it that way. Instead, it’s mentioned briefly, lumped into a list of perks, or skipped altogether. If you’re doing this, you’re not alone—but you are likely out of alignment with what CMS wants you to communicate.

This isn’t just about compliance. When you present the AWV the right way, you enhance the perceived value of the Medicare plan. You also help clients make smarter use of their benefits, which reinforces your credibility and strengthens retention.

What CMS Actually Wants Agents to Highlight

CMS doesn’t require you to be a clinician, but it does expect that you highlight certain benefits in a manner that reflects their purpose in the broader healthcare system. For the Annual Wellness Visit, this includes:

Describing it as a preventive planning session, not a full physical exam
Clarifying the timeline—the AWV becomes available 12 months after a client’s Medicare Part B effective date, and is covered once every 12 months thereafter
Emphasizing that it’s free only if the provider follows specific preventive care criteria
Not confusing it with the one-time Welcome to Medicare visit, which is available only in the first 12 months after enrolling in Part B

Your messaging should support CMS’s broader goal: reduce downstream costs by encouraging enrollees to stay ahead of illness, rather than respond to it after symptoms develop.

What the Visit Actually Includes—and Why That Matters

When explained correctly, the AWV sounds more strategic than many clients expect. You should be focusing your language around what it builds, not just what it checks:

A personalized prevention plan, based on health history and current risk factors
Cognitive impairment screening
Advance care planning (upon request)
Review of current medications
Routine checks like height, weight, and blood pressure
Assessment of functional ability and safety risks

These aren’t just checkboxes. They’re CMS-approved tools for identifying health risks before they escalate into more costly treatments. The result? Higher client satisfaction and potentially lower healthcare expenses down the line.

Why You Should Stop Saying “Free Checkup”

One of the most common ways agents inadvertently mislead clients is by calling the Annual Wellness Visit a “free checkup.” Not only is this incorrect—it opens the door to client frustration. Here’s why:

If the provider includes tests or treatments that aren’t preventive, the visit might generate a bill
If the client expects a full physical exam, they may feel misled
CMS doesn’t label the AWV as a physical exam, and your messaging should reflect that distinction

Instead, say: “It’s a planning appointment to help you and your doctor identify health risks and build a personalized prevention plan.”

The Timeline Confusion: Clear It Up Before It Costs You

Too many clients miss out on the Annual Wellness Visit simply because they—and sometimes their agents—don’t understand when it’s available. Here’s what you need to clarify:

The Welcome to Medicare visit is only available during the first 12 months after enrolling in Part B
The Annual Wellness Visit is only available after that first year—and every 12 months after the first AWV
It’s not available twice in a year, even if the client switches plans

Missing this sequence can lead to frustration and potentially unexpected charges. It also makes it look like you didn’t prepare your client for the plan experience.

Your Role Isn’t to Explain the Visit—It’s to Frame the Benefit

You don’t need to memorize clinical codes or billing processes. But you do need to help your client understand why this benefit matters and how it fits into their broader Medicare coverage. CMS wants agents to act as benefit educators, not medical professionals—but those roles aren’t as separate as you think.

Your framing should do the following:

Reinforce the value of preventive care
Encourage annual participation, not one-time use
Normalize proactive health planning
Clarify what the client should and shouldn’t expect

The better you frame the visit, the more confident your client will be using it. That leads to better engagement, and CMS notices those patterns.

Positioning the AWV in Your Medicare Presentation

You might already be covering preventive benefits in your client discussions, but it’s time to isolate the Annual Wellness Visit as a separate focal point. Here’s how to incorporate it:

During Initial Plan Discussions

When discussing benefits, highlight the AWV as a “no-cost annual benefit when preventive-only care is provided.”
Use plain language: “This visit helps your doctor spot risks before they turn into health problems.”
Reinforce it as a strategic planning session—not a typical appointment.

During Annual Reviews

Ask: “Did you schedule your Annual Wellness Visit this year?”
If not, walk them through how and when they can use it
Offer to help clarify what counts as preventive vs. diagnostic during their next visit

In Educational Materials or Mailings

Dedicate a paragraph or section specifically to the AWV
Use visual aids or comparison charts to show how it differs from other services
Always include the 12-month timing reminder

What Happens When You Don’t Emphasize It Enough

When you skip over the Annual Wellness Visit or describe it poorly, the downstream consequences can affect both your clients and your reputation:

Lower preventive care usage, which can affect plan ratings and member retention
Client dissatisfaction when unexpected charges arise
Missed opportunities for early risk detection, leading to more complex health issues later

This isn’t a minor oversight—it’s a gap in how you’re representing the Medicare experience. CMS puts strong emphasis on this visit because it’s evidence-based and cost-effective. You should, too.

Turn Preventive Benefits into Long-Term Relationships

The agents who stand out in 2025 aren’t the ones who simply get the sale. They’re the ones who know how to frame benefits the way CMS intends—and use them to build real relationships. Preventive care, especially the Annual Wellness Visit, is your opportunity to:

Show that you care beyond enrollment
Offer practical value throughout the year
Retain clients through education and follow-up

Most importantly, it builds trust. That trust creates referrals, renewals, and a reputation for expertise.

Your Clients Deserve Better Prevention—and You Deserve Better Tools

When you take the time to align your messaging with CMS goals, your value as an agent multiplies. You’re not just helping clients use a benefit—you’re giving them a strategy. And in today’s Medicare market, that’s the difference between a transactional agent and a trusted professional.

If you’re ready to start presenting Medicare benefits in a way that reflects CMS’s priorities—and earns lasting client trust—then we’re here to help. At BedrockMD, we offer training, marketing tools, and client education resources that help professionals like you communicate with confidence and grow your business.