Your Rights: Can Seniors Refuse a Medicare Wellness Visit?

By James AndersonLast Updated April 23, 2025

Introduction: Understanding Medicare Wellness Visits

Medicare wellness visits are annual preventive care appointments offered to seniors covered under Medicare Part B. Often misunderstood, these visits aim to assess overall health, identify risk factors, and create a personalized prevention plan. But a common question arises among Medicare beneficiaries: Can you refuse a Medicare wellness visit? This article explores your rights, what the visit entails, the benefits, implications of refusal, and actionable guidance for making informed choices.

Are Medicare Wellness Visits Mandatory?

Medicare wellness visits are not mandatory . As a Medicare beneficiary, you have the legal right to refuse a Medicare wellness visit without any penalty or impact on your coverage. Participation is entirely voluntary, and declining the visit will not affect your eligibility for Medicare or any other benefits you receive through the program. The Centers for Medicare & Medicaid Services (CMS) and multiple healthcare organizations confirm that seniors have full autonomy in this choice [4] , [1] , [2] , [5] .

What Happens During a Medicare Wellness Visit?

The annual Medicare wellness visit is
not
a physical exam. Instead, it focuses on evaluating your overall health and risk factors. Typical activities during the visit include:

Reviewing your medical and family history
Checking routine measurements (height, weight, blood pressure)
Assessing your functional ability and mobility
Screening for cognitive impairment, depression, and hearing issues
Discussing your medications, supplements, and substance use
Providing health advice and scheduling needed preventive services (e.g., diabetes screening, mammograms)
Updating your list of preferred providers and care goals

Some providers may ask you to complete a health risk assessment before the appointment, which helps tailor the discussion and care plan during your visit [4] .

Benefits of Participating in Wellness Visits

Medicare wellness visits offer several potential advantages:

Early Detection: Regular assessments may catch health issues early, improving outcomes and quality of life.
Preventive Care: Your provider can recommend screenings, immunizations, and lifestyle changes to prevent disease.
Personalized Planning: Visits help create a customized health plan based on your risks, needs, and preferences.
No Cost: Medicare covers the annual wellness visit at no out-of-pocket cost when performed by a provider who accepts Medicare assignment [4] .

While declining the visit does not affect your coverage, you might miss out on these preventive benefits [2] , [5] .

Refusing a Medicare Wellness Visit: What You Need to Know

Seniors have the right to refuse both in-office and in-home wellness visits. In-home visits, sometimes offered by Medicare Advantage plans, are equally voluntary. You cannot be compelled to participate, and declining such visits does not impact doctor-patient confidentiality or your benefits [3] . If you feel pressured or uncomfortable, communicate your preference directly to the provider or plan representative.

There are no penalties or coverage limitations for refusing the annual wellness visit. Your regular medical care, treatment for chronic conditions, and eligibility for other preventive services remain unchanged [2] .

Making the Best Decision for Your Health

Choosing whether or not to participate in a Medicare wellness visit is a personal decision. Consider the following steps:

Discuss With Your Provider: Talk to your primary care physician or healthcare team about the purpose, benefits, and any concerns you have regarding the wellness visit. Ask about alternative ways to monitor your health if you decline.
Evaluate Your Needs: Consider your current health status, risk factors, and preferences. If you already have a well-established care plan, you may choose to focus on routine check-ups or chronic disease management instead.
Understand Preventive Care Options: Even if you refuse the wellness visit, you may still be eligible for other preventive services covered by Medicare, such as screenings and vaccinations. Discuss these options with your provider.
Know Your Rights: If you receive requests for in-home visits or feel pressured, remember that participation is entirely voluntary. You can decline by informing your provider or plan administrator.
Document Your Decisions: To avoid confusion, consider documenting your refusal in writing or confirming it through your provider’s patient portal.

Practical Guidance: Accessing or Declining Medicare Wellness Visits

To schedule a Medicare wellness visit:

Contact your primary care provider’s office and request an “Annual Wellness Visit” under Medicare Part B.
Confirm that your provider accepts Medicare assignment to ensure no out-of-pocket cost [4] .

To refuse a Medicare wellness visit:

Inform your provider or plan administrator verbally or in writing that you do not wish to participate.
If you receive calls or letters about in-home visits, you can simply say “I decline” or “I do not wish to participate at this time.” No further justification is required.
If you experience unwanted pressure, contact your provider’s office manager or Medicare plan’s customer service for support.

For more information about your rights and options, you can visit the official Medicare website and search “Annual Wellness Visit” or call 1-800-MEDICARE for guidance. Avoid sharing personal information unless you are interacting with verified, official sources.

Potential Challenges and Solutions

Some seniors report feeling pressured by providers or insurance plans to schedule wellness visits, especially in-home assessments. If this occurs:

Communicate Clearly: Reiterate your decision and ask for documentation confirming your refusal.
Seek Advocacy: If you feel your rights are being violated, contact your local Area Agency on Aging or a healthcare advocacy group for assistance.
Stay Informed: Regularly review your Medicare plan documents and official communications to ensure you are aware of your rights and options.

Remember, healthcare decisions should always align with your comfort and needs. You are empowered to accept or refuse any preventive service offered under Medicare.

Alternatives to Wellness Visits

If you choose to decline the annual wellness visit, you still have access to:

Routine medical check-ups and chronic disease management
Screenings (such as mammograms, colonoscopies, diabetes checks) covered by Medicare
Immunizations and preventive counseling services

Discuss with your provider which services are most beneficial based on your health profile. You can also request specific screenings or assessments individually, rather than through the annual wellness visit.

Key Takeaways

Seniors have the right to refuse Medicare wellness visits without losing coverage or benefits. While these visits offer valuable preventive care, participation is entirely voluntary. Make healthcare choices that reflect your preferences, needs, and comfort level. For more information, consult with your provider or contact Medicare directly.