Medicare annual wellness visit: chronic condition checkpoints to review

The envelope from Medicare sat on my kitchen table for a week before I opened it. “Annual Wellness Visit,” it said—three words that sounded both official and oddly gentle, like an invitation to take stock without judgment. I’ve had my share of “problem visits,” the ones where blood pressure is spiking or a new ache demands attention. This felt different. It made me wonder: if I treat the Annual Wellness Visit as my yearly tune-up, could I walk in with a short, sane checklist that actually fits real life with chronic conditions? That thought stuck with me, so I wrote out what I now review each year and how I keep it honest, doable, and kind to my future self.

The visit I stopped treating like a physical

I used to expect a full head-to-toe exam. Then I learned the Medicare Annual Wellness Visit (AWV) is more about prevention planning—talking through risks, updating history, spotting things early (mood, memory, falls), and shaping a personalized plan for the next 12 months. That shift made the whole thing click for me. Instead of chasing everything, I pick a few high-value checkpoints and tie them to my existing conditions. If I need hands-on care for an urgent issue, that’s a separate problem visit. But the AWV is where I choose the map for the year ahead. To confirm what’s covered and what isn’t, it helps to skim the Medicare overview so expectations match reality.

  • Bring what matters: a one-page medication list (including supplements), home BP/weight logs, and your top 3 goals.
  • Use the AWV for planning: screenings, vaccines, and care coordination for chronic conditions.
  • Keep limits in mind: the AWV isn’t a fix-everything visit; urgent symptoms deserve their own appointment.

What I bring so the conversation stays practical

My best visits happen when I bring proof instead of vague memory. I print a one-pager: diagnoses, surgeries, allergies, and every pill I take. I note how often I actually use my inhaler, how I’m sleeping, and what “good weeks” look like. I also add a tiny wish list—things like “I want to walk 20 minutes without stopping” rather than “be healthier.” For vaccines and screening timelines, I double-check the big picture using credible sources such as the USPSTF’s list of A/B recommendations (a simple way to see what matters by age) and the CDC’s adult vaccine schedule:

Just skimming those pages keeps me from forgetting something basic, like a shingles vaccine or a colon cancer screen timeline. It also helps me ask, “Which of these apply to me given my conditions?” instead of “Do I need everything?”

The chronic-condition checkpoints I work through one by one

I block 15 minutes the night before my AWV to update this list. I don’t try to cover every disease under the sun—only what’s on my chart or runs in my family. Here’s how I structure it (feel free to copy/paste and tweak).

  • Blood pressure & heart risks: Recent home BP averages (time of day, cuff size), last lipid panel, any side effects from BP meds or statins (cough, leg aches, lightheadedness). Ask whether targets and meds still fit your age and risks, and whether lifestyle changes could let you simplify the regimen rather than add more pills.
  • Diabetes or prediabetes: Last A1C and what it looked like across the year, episodes of lows/highs, foot checks, and eye exam status. I like to peek at the ADA Standards of Care 2025 as a compass, then ask my clinician to translate what’s relevant for me.
  • Kidney health: Most recent eGFR and urine albumin-creatinine ratio if diabetes or hypertension are in the picture. If numbers moved, I ask what could be medication-related, dehydration, or illness-related versus true decline.
  • Lung health (asthma/COPD): Rescue inhaler use per week, any nighttime symptoms, and inhaler technique (I bring the device to re-check my technique—amazing how often that helps). If there’s a smoking history, I ask about screening eligibility in plain English.
  • Heart rhythm & anticoagulation (if AFib or clots in the past): Any bleeding/bruising concerns, dose checks, and whether newer options or dose adjustments could reduce risk without increasing hassles.
  • Bone health: DEXA scan timing, calcium/vitamin D in food versus supplements, balance or strength training I’ll actually do (chair rises count!).
  • Mental health: Mood, motivation, anxiety spikes, grief, and any medication effects (sleepiness, agitation). I bring a few sentences describing how my days feel, not just a checkbox score.
  • Sleep & daytime energy: Snoring or witnessed apneas, morning headaches, irregular sleep windows, and whether insomnia is behavior-related or pain-related. CPAP use if applicable—how many nights, rough hours.
  • Pain & function: Which activities pain blocks (walking dog, gardening), which meds or stretches help, and any side effects (constipation with opioids, stomach upset with NSAIDs). I ask about non-drug options first, then talk about safer medication use if needed.

My rule of thumb is to attach each checkpoint to at least one specific next step—a lab, a referral, or a tiny habit change—so the plan doesn’t dissolve after I leave the office.

The medication clean-up I only trust to the calendar

Once a year I do a true med reconciliation with my clinician or pharmacist. I bring every bottle (or a clear list with dose and timing), plus the over-the-counter stuff I’m convinced “doesn’t count.” We cross-check for duplications (two drugs doing the same job), interactions (especially with acid-reducers, blood thinners, or herbal supplements), and side effects I’ve quietly normalized. This is when I ask about deprescribing candidates—meds that no longer fit my risks or goals—and whether a long-standing dose is still appropriate as kidneys, weight, or other conditions change. I also ask about vaccines I’m due for (flu, COVID-19, pneumococcal, shingles, tetanus), using the CDC adult schedule as a prompt rather than a demand list.

What the AWV covers that I originally overlooked

The AWV includes a health risk assessment, a review of meds and providers, routine measurements, and screening for memory, mood, and fall risk. That last part is bigger than it sounds—short tests can hint at conditions (depression, mild cognitive impairment) that change how we approach everything else. It also generates a personalized prevention plan for the coming year. Reading the Medicare page ahead of time helped me recognize what’s built-in so I could use it rather than sitting politely while time ran out.

Turning checklists into a simple one-page plan

After the visit, I rewrite the plan in my own words. I keep it to one page with three sections: “Do now,” “Schedule this year,” and “Watch for.” If it’s longer than that, I won’t read it later. Here’s the minimal version that works for me:

  • Do now: Book the next labs/screenings, refill critical meds, set up a 3-month follow-up if we changed anything important.
  • Schedule this year: Vaccines due, next DEXA or colon screen window, eye or foot exams if diabetes is in play.
  • Watch for: Side effects worth calling about, symptom thresholds (e.g., BP above X for Y days), and a backup plan for flares.

If multiple chronic conditions stack up, I ask about coordinated programs like care coordination or team-based management. AHRQ’s pages on care coordination gave me language to ask for the right help without feeling pushy, and to understand what a coordinated plan actually means day-to-day (AHRQ Care Coordination).

Little habits I’ve tested that punch above their weight

These aren’t glamorous, but they stick:

  • Ten-minute tidy for pills: I set a monthly reminder to count what I have, toss expired meds safely, and reorder early. It prevents “rationing” at the worst time.
  • Walking as a vital sign: I track minutes, not steps. I write a weekly line—“3×20 this week”—right on my AWV plan. When pain flares, I define a tiny substitute (gentle range-of-motion while the coffee brews).
  • Fridge note for low moods: Three names to text and one outdoor place to go. It sounds corny; it beats the alternative.
  • Device practice: Once a quarter I practice inhaler or CPAP technique with a video from a trusted source or at the clinic. Every time, something improves.

When I’m not sure whether a habit is worth it, I gut-check against trusted guidance (USPSTF for screenings, ADA for diabetes care, and the CDC for vaccines). I’m not trying to memorize guidelines; I’m trying to keep my plan pointed in a credible direction.

Signals that tell me to call sooner than next year

I keep a short list taped to the inside of a kitchen cabinet—simple, plain-English reasons to call the clinic rather than wait for the next AWV:

  • Sudden changes: chest pain or pressure, trouble breathing, new weakness/numbness, severe headache, fainting—these are emergency-level and call for 911.
  • Trends, not blips: home BP readings or blood sugars consistently out of the usual range for several days, especially with symptoms (dizziness, confusion, shortness of breath).
  • Medication red flags: bleeding or black stools if on blood thinners; swelling of face/tongue; rash with fever; new confusion; uncontrolled pain on current meds.
  • Function drops: a week where I can’t do basics I usually manage (walk to the mailbox, shower safely) or new falls/unsteadiness.
  • Mood or memory shifts: persistent hopelessness, thoughts of self-harm, or family noticing memory changes—these deserve prompt attention.

For non-urgent questions, I use the patient portal and attach a photo (swollen ankle, pill bottle label). For anything that feels like an emergency, I don’t message—I call 911. It helps to write these choices down before I need them.

What I’m keeping and what I’m letting go

What I’m keeping: the idea that a wellness visit isn’t about being “perfect,” it’s about direction. Three specific actions beat a grocery list of intentions. I’m also keeping my one-page plan and the habit of printing it. What I’m letting go: the urge to do everything at once, and the quiet shame when a year didn’t go as planned. If you want a simple way to use credible guardrails, these have served me well:

FAQ

1) Is the Annual Wellness Visit the same as a “physical”?
Answer: Not exactly. The AWV focuses on risk review, screening, and a prevention plan. If you have a new or urgent problem, that usually needs its own visit. You can preview what’s included on the Medicare page.

2) Can I review chronic conditions during the AWV?
Answer: Yes—especially to update goals, reconcile meds, and schedule the right monitoring. The AWV is ideal for aligning your plan with trusted guidance (e.g., USPSTF screenings, CDC vaccines), but active problems may require additional visits.

3) What should I bring to make it efficient?
Answer: A current med/supplement list, recent home readings (BP, glucose), your top 3 health goals, dates of last vaccines/screens, and questions you don’t want to forget. Even a simple one-page summary helps the team help you.

4) How do I keep from forgetting follow-ups?
Answer: Before leaving, schedule what you can (labs, scans, next check-in). Put the plan on one page: “Do now,” “Schedule this year,” and “Watch for.” Many clinics will print or portal-message a plan—ask for it.

5) Where do I find trustworthy guidance without reading a textbook?
Answer: For screenings, start with the USPSTF A/B list. For vaccines, check the CDC adult schedule. For diabetes-specific care questions, the ADA Standards of Care 2025 provide clinician-level guidance you can use as a reference point in conversation.

Sources & References

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).