To fill out a Medicare comprehensive health assessment, gather your current medications, a list of your chronic conditions and recent hospitalizations, your vaccination record, and any known drug allergies, then answer every question about your health, daily activities, and home situation as accurately as you can. The assessment can be completed in your doctor’s office, at home with a visiting clinician, by phone, through your plan’s online portal, or on a paper form your plan mails to you. Honest, complete answers are what turn the form into a care plan that actually matches your needs.
What to Have Ready Before You Start
A few minutes of preparation makes the assessment go faster and keeps the answers accurate. Pull these together before your appointment or before you sit down with the form:
- A current medication list. Every prescription, over-the-counter drug, and supplement, with the dose, how often you take it, and which provider prescribed it.
- A short medical history. Your chronic conditions with approximate diagnosis dates, any surgeries, and any hospitalizations or emergency visits in the past year. Discharge summaries from recent hospital stays help.
- Immunization dates. Recent flu, pneumonia, and shingles vaccinations in particular.
- Allergy information. Drug allergies and the type of reaction each one causes. Omissions here can create real safety problems later.
- Your insurance card and the name of your primary care provider.
- Advance directive information. If you have a living will or healthcare power of attorney, note it. The Annual Wellness Visit includes an optional advance care planning conversation.1Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment
If you receive a paper form, check that it carries the current plan year. Older forms may be missing required questions that have been added recently, particularly the housing, food, and transportation questions now required for Special Needs Plan assessments.2Centers for Medicare & Medicaid Services. Medicare Managed Care Manual Chapter 16-B – Special Needs Plans
How You Can Complete the Assessment
Your plan will usually offer more than one way to complete the HRA. Pick whichever setting lets you give the most careful answers.
At Your Doctor’s Office
The most common setting is a visit with your primary care provider, usually during an Annual Wellness Visit. Your doctor reviews the questionnaire with you, takes physical measurements such as height, weight, and blood pressure, and screens for cognitive and mood changes in the same appointment.1Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment You pay nothing for the Annual Wellness Visit itself when your provider accepts Medicare assignment, and the Part B deductible does not apply. If your doctor orders tests or other services beyond the preventive visit at the same appointment, those extras may carry separate cost sharing.3Medicare. Yearly Wellness Visits
At Home
Many Medicare Advantage plans arrange for a nurse practitioner, physician assistant, or other licensed clinician to come to your home to complete the HRA. The clinician often works for a third-party vendor contracted by the plan rather than for your own doctor’s office.4U.S. Department of Health and Human Services Office of Inspector General. Medicare Advantage – Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions A home visit lets the clinician see things a clinic visit would miss, such as stairs that create a fall risk or limited access to food.5Better Medicare Alliance. How Medicare Advantage In-Home Health Assessments Keep Seniors Healthier
In-home assessments are voluntary. If your plan calls to schedule one, you can accept, decline, or ask to complete the assessment at your doctor’s office instead. Your plan must document your decision if you choose not to participate.6eCFR. 42 CFR 422.101 – Requirements Relating to Basic Benefits
By Phone, Online, or on Paper
Some plans let you complete the questionnaire over the phone with a plan representative, through the member portal on the plan’s website, or on a paper form mailed to your home. The specific options depend on your insurer. Online submission through the portal is usually the fastest route and gives you confirmation that the form was received. If you use the paper form, keep a copy for your own records before mailing it back using the envelope the plan provides.
How to Answer the Questions
The questionnaire varies by plan, but CMS requires every HRA to cover the same core topics: demographics, a self-assessment of your health status, psychosocial risks, behavioral risks, activities of daily living, and instrumental activities of daily living.1Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment Special Needs Plan assessments cover all of these and add questions about housing, food, and transportation.
Medical History and Medications
Expect questions about your diagnosed chronic conditions, past surgeries, and any hospital stays or emergency visits in the past year. For each medication, give the name, dosage, frequency, and prescriber. Flag drug allergies clearly, including the reaction. The questionnaire also asks about your immunization history.
Activities of Daily Living
Activities of daily living (ADLs) are the basic self-care tasks: dressing, feeding yourself, toileting, grooming, getting around, and bathing. If you need help with any of them, say so and describe the level of help. These answers drive decisions about home health services or durable medical equipment such as grab bars or a walker.1Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment
Instrumental activities of daily living (IADLs) cover more complex tasks: using the phone, preparing meals, housekeeping, laundry, transportation, shopping, taking medications correctly, and managing finances. Trouble in any of these areas can signal a need for community support services or a caregiver even when basic self-care is still manageable.
Behavioral and Psychosocial Questions
The HRA screens for tobacco use, physical activity, nutrition, alcohol consumption, and home safety, along with depression, stress, loneliness, social isolation, pain, and fatigue. These questions can feel personal, but your answers determine whether your plan connects you with mental health resources, counseling, or safety support.
Housing, Food, and Transportation
If you are in a Special Needs Plan, the assessment includes screening questions on housing stability, food security, and access to transportation, using instruments CMS specifies.2Centers for Medicare & Medicaid Services. Medicare Managed Care Manual Chapter 16-B – Special Needs Plans Honest answers here can qualify you for supplemental benefits the plan offers in these areas.
A Note on Accuracy
Answer the ADL, IADL, and behavioral questions honestly. Understating difficulty with daily tasks can leave real needs out of your care plan; overstating them can trigger evaluations that don’t help you. The goal is an accurate picture so the plan can match resources to your actual situation.
Submitting the Form and What Happens Next
How you submit depends on how you completed the HRA. In a clinical visit, the provider enters your answers and submits them for you. For an in-home assessment, the visiting clinician handles submission. Online portal submissions go through on completion; phone submissions are entered by the representative on the call. Paper forms go back in the envelope your plan provides, and it is worth keeping a photocopy.
Once your plan has the completed assessment, a care plan follows. For Special Needs Plan enrollees, the plan must develop a comprehensive individualized care plan within 90 days of the initial HRA or 90 days after enrollment, whichever is later. The care plan is built by an interdisciplinary team with your participation and lists the specific services and benefits you will receive.6eCFR. 42 CFR 422.101 – Requirements Relating to Basic Benefits For standard Medicare Advantage enrollees and those in Original Medicare, the Annual Wellness Visit produces a written screening schedule for the next five to ten years, a list of risk factors, and referrals to counseling or prevention programs.1Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment
Depending on your answers, you may also qualify for additional services. Plans may offer Special Supplemental Benefits for the Chronically Ill, such as home-delivered meals or non-medical transportation, when enrollees meet specific criteria tied to chronic conditions, and HRA results are one of the tools plans use to decide eligibility.7Centers for Medicare & Medicaid Services. Implementing Supplemental Benefits for Chronically Ill Enrollees If the assessment identifies two or more serious chronic conditions expected to last at least a year, you may be eligible for chronic care management services, which you have to sign up for separately on a monthly basis.8Medicare. Chronic Care Management Services
One practical tip: if a condition shows up on the assessment, make sure it also gets followed up with your regular providers through an actual visit, test, or treatment. A diagnosis that appears only on an in-home HRA, with no corresponding care, has drawn regulator scrutiny and, more importantly, doesn’t help you.4U.S. Department of Health and Human Services Office of Inspector General. Medicare Advantage – Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions
Rewards for Completing It
Many Medicare Advantage plans offer a small incentive, usually a gift card, for completing the annual HRA. Gift cards typically range from $10 to $100 and cannot be redeemable for cash. Some plans offer points or tokens redeemable for fitness accessories or other health-related items instead.9KFF. Medicare Advantage Insurers Often Use Rewards and Incentives to Encourage Enrollees to Complete Health Risk Assessments Check your plan’s member materials or call the number on your insurance card for details.
Rewards are allowed for completing a health assessment, but not for enrolling in a plan. If someone offers a gift card in exchange for signing up for Medicare Advantage, that is not a legitimate incentive.
Your Privacy
The information you share on the HRA is protected under HIPAA, the same federal law that covers your other medical records. Your plan can use the data for treatment coordination, care planning, and payment, but cannot share identifiable health information for unrelated purposes without your authorization. Online portal submissions are transmitted through encrypted channels, and paper forms are handled under the same privacy and security standards as any other medical record.