Does Medicare Cover an Annual Physical? Wellness Visits Explained

Original Medicare Part B covers a one-time “Welcome to Medicare” preventive visit and, when you are eligible, a yearly “Wellness” visit. Medicare.gov says neither visit is a routine or comprehensive physical exam. The covered visits focus on prevention planning, health risks, medical history, and recommended screenings rather than a head-to-toe physical.

That distinction can affect your bill. If you ask for an annual physical but the appointment is scheduled or billed as a routine physical, Original Medicare may not cover it. When making the appointment, use the exact name of the preventive visit you want and ask what services the office expects to provide.

The “Welcome to Medicare” preventive visit is available once during the first 12 months that you have Part B. Medicare.gov describes it as a preventive check-up that reviews your medical and social history, family history, medications, risk factors, and the screenings and vaccines that may be appropriate for you.

The visit can include routine measurements, a simple vision test, a depression risk review, information about preventive services, and a written prevention plan. It is not a comprehensive physical, and it is not available after the first 12 months of Part B coverage.

After you have had Part B for more than 12 months, you may qualify for a yearly “Wellness” visit. Your first yearly Wellness visit cannot occur within 12 months of your Part B enrollment or your Welcome to Medicare visit. You do not have to complete a Welcome visit before qualifying for a yearly Wellness visit.

The yearly visit is conversation-based. It generally includes a Health Risk Assessment, routine measurements, a review of your medical and family history and prescriptions, health advice, a cognitive assessment, and a written schedule for screenings, vaccines, and other preventive services.

Medicare.gov says you pay nothing for the covered Welcome or yearly Wellness visit if your provider accepts assignment, and the Part B deductible does not apply to the preventive visit itself. Accepting assignment means the provider agrees to accept the Medicare-approved amount as full payment for covered services.

You may still owe coinsurance, the Part B deductible, or the full cost of an item if the provider performs additional tests or services that are not included in the preventive benefit. Examples can include evaluating a new symptom, managing an existing condition, ordering certain tests, or performing a routine physical exam. Coverage and cost depend on the exact service and why it is provided.

A Wellness visit can produce a checklist of recommended screenings and vaccines, but the visit does not automatically make every follow-up service free. Medicare preventive services have separate eligibility, frequency, provider, and cost-sharing rules. A service may be fully covered in one situation and carry a cost in another.

Before scheduling a screening, ask whether Medicare covers it for your age, risk factors, timing, and diagnosis. You can also review Medicare.gov’s preventive and screening services list or sign in to your Medicare account to check services that may be due.

When you schedule, say whether you want the Welcome to Medicare preventive visit or the yearly Wellness visit. Ask whether the clinician plans to address other medical concerns during the same appointment and whether those services may be billed separately.

If you have a new symptom or an urgent concern, do not delay care simply to preserve a no-cost preventive visit. Instead, tell the office what you need and ask how the appointment may be billed. The office can explain its expected charges, while Medicare or your plan can explain coverage rules.

Medicare Advantage plans must cover the Medicare-covered services included in Parts A and B, but networks, referral rules, cost sharing, and coverage for additional services can vary. Some plans may offer a routine physical or other preventive benefits beyond Original Medicare, but a plan’s extra coverage should be verified in current plan documents.

If you have Medicare Advantage, confirm that the provider is in network and ask the plan how the visit and any added services are covered. Do not assume a benefit works the same way because two plans use similar names or both advertise preventive care.

Confirm how long you have had Part B, which preventive visit you are eligible for, whether the provider accepts assignment or participates in your Medicare Advantage network, and whether additional concerns will be handled during the visit. Bring your medication list, medical and immunization records, and family health history when the office requests them.

Ask: Is this appointment being scheduled as my Welcome to Medicare visit or yearly Wellness visit? Are any planned services outside that benefit? Could I owe the Part B deductible, coinsurance, a plan copay, or the full charge? Getting those answers in advance can reduce billing surprises without replacing care you need.

Medicare.gov: “Yearly ‘Wellness’ visits,” “Welcome to Medicare preventive visit,” “Preventive and screening services,” and “How do Medicare Advantage Plans work?” These official pages explain eligibility, timing, included prevention-planning services, assignment-based costs, why additional services or a routine physical exam may result in a separate charge, and how Medicare Advantage coverage can use plan-specific rules.