Annual Physical Exam Checklist by Age: What to Expect

An annual physical exam checklist by age helps you walk into your doctor’s office prepared and ensures nothing important falls through the cracks. Preventive screenings change as you get older — what a 25-year-old needs is very different from what a 55-year-old requires — and they also depend on your sex, personal history, and family history.

This guide organizes the key tests, screenings, and conversations you can expect at your annual physical exam by decade, drawing on recommendations from the U.S. Preventive Services Task Force (USPSTF), the CDC, and other leading health organizations. Treat it as a starting point for a conversation, not a rigid prescription: guidelines evolve, and your clinician decides which apply to you.

What Every Annual Physical Includes (All Ages)

Regardless of your age, a standard annual physical typically covers a consistent set of baseline assessments. Your provider will measure vital signs — blood pressure, heart rate, respiratory rate, temperature, and body mass index (BMI). They will also review your medical history, current medications, family health history, and lifestyle habits such as diet, physical activity, sleep, alcohol use, and tobacco use.

A head-to-toe physical examination usually includes listening to your heart and lungs, checking your eyes and ears, palpating your abdomen, examining your skin, and assessing your reflexes and neurological function. For a detailed look at the visit itself, see our guide on what an annual physical consists of.

It is worth noting that an annual physical and a Medicare Annual Wellness Visit are not the same thing. The physical is a hands-on clinical exam, while the wellness visit focuses on health risk assessment and care planning. Both are valuable, but they serve different purposes — a distinction that matters for billing, as we explain below.

Ages 18 to 29: Building a Health Baseline

Young adults are establishing the reference points that clinicians will track for decades. Common components of the annual physical in your 20s include:

• Blood pressure screening — generally at least every two years if readings are normal (below 120/80), and more often if elevated.
• Cholesterol (lipid) panel — screening timing is individualized based on cardiovascular risk factors; many clinicians establish a baseline in early adulthood and repeat it periodically.
• STI screening — chlamydia and gonorrhea screening for sexually active women 24 and under (and older women at increased risk), and HIV screening at least once for adults, per USPSTF.
• Cervical cancer screening — the USPSTF recommends starting at age 21, typically with a Pap test every three years for ages 21 to 29. (Guidance from some other bodies differs slightly and continues to evolve, so confirm the current approach with your clinician.)
• Depression and anxiety screening — the USPSTF recommends screening adults for depression, and for anxiety disorders in adults through age 64.
• Immunizations — an annual flu vaccine, a Tdap/Td booster on schedule, staying current on COVID-19 vaccination per CDC guidance, and any needed catch-up vaccines (for example, HPV series).

This decade is also the time to discuss family history in detail. Knowing whether heart disease, diabetes, or cancer runs in your family helps your clinician tailor screening timelines for the years ahead.

Ages 30 to 39: Monitoring Emerging Risks

Your 30s are when chronic disease risk factors often first appear. The checklist commonly expands to include:

• Blood glucose or A1C testing — the USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 who are overweight or have obesity. Screening may begin earlier with additional risk factors such as family history or certain ethnic backgrounds.
• Skin checks — the USPSTF has not issued a universal recommendation, but many clinicians suggest periodic skin exams for people with fair skin, a history of significant sun exposure or sunburns, or a family history of melanoma.
• Cervical cancer screening update — from age 30, options generally include a Pap plus HPV co-test every five years, primary HPV testing every five years, or a Pap alone every three years.
• Continued cardiovascular monitoring — blood pressure and lipid checks remain important, especially if numbers have been trending upward.

Conversations about stress, sleep, and mental health become increasingly important during this decade as career and family demands intensify.

Ages 40 to 49: Stepping Up Screenings

The 40s bring more targeted cancer screenings and closer metabolic monitoring:

• Mammography — in its final 2024 update, the USPSTF recommends biennial (every other year) screening mammography for women aged 40 to 74 at average risk (Grade B). Women with higher risk may start earlier or screen more often; discuss your personal risk with your clinician.
• Colorectal cancer screening — the USPSTF recommends starting at age 45 for average-risk adults. Options include colonoscopy every 10 years, an annual stool-based FIT, or a stool DNA test every one to three years, among others.
• Diabetes screening — if not already started, glucose or A1C testing is commonly done for adults 35 to 70 who are overweight or have obesity.
• Eye and vision checks — many eye-care organizations suggest a baseline comprehensive eye exam around age 40, with follow-up intervals based on findings and risk.
• Cardiovascular risk assessment — your clinician may estimate your 10-year cardiovascular (ASCVD) risk and discuss whether a statin is appropriate, in line with USPSTF guidance for adults 40 to 75 with risk factors.

This is also when thyroid testing may be considered, particularly for people with unexplained weight changes, fatigue, or mood shifts.

Ages 50 to 64: The Critical Screening Decade

More screenings come online in your 50s, and the payoff for catching problems early is high:

• Lung cancer screening — annual low-dose CT for adults aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years, per the USPSTF.
• Bone density scan (DEXA) — recommended for women at 65, but may start earlier for those with risk factors such as low body weight, smoking, certain medications, or a family history of osteoporosis.
• Abdominal aortic aneurysm (AAA) screening — a one-time ultrasound for men aged 65 to 75 who have ever smoked (planning for this often begins in the 50s).
• Hepatitis C screening — one-time screening for all adults aged 18 to 79 who have not been tested.
• Shingles vaccine — the CDC recommends Shingrix (two doses) for adults 50 and older.

If you have not yet started colorectal cancer screening, it is important to do so. Colorectal cancer is highly treatable when caught early, according to the American Cancer Society — one reason it is a cornerstone of midlife prevention.

Ages 65 and Older: Medicare and Beyond

At 65, most Americans become eligible for Medicare, which changes the landscape of preventive coverage. Your annual physical exam checklist by age 65-plus commonly includes:

• Medicare Annual Wellness Visit — covered at no cost under Medicare Part B for those who have had Part B for more than 12 months. This is a health risk assessment and care-planning visit, not a traditional hands-on physical. Learn more in our annual wellness exam checklist.
• Bone density scan — DEXA screening for women 65 and older, and for men and younger women with risk factors, at intervals your clinician recommends.
• Cognitive assessment — a check of memory and thinking is part of the Medicare Annual Wellness Visit.
• Fall risk assessment — the USPSTF recommends exercise interventions to help prevent falls in community-dwelling adults 65 and older who are at increased risk.
• Pneumococcal and other vaccines — the CDC recommends pneumococcal vaccination for adults 65 and older, along with annual flu, RSV vaccination for eligible older adults, and staying current on COVID-19 and shingles vaccines.
• Continued cancer screenings — colorectal, breast, and lung cancer screening continue based on individual risk, overall health, and life-expectancy discussions with your clinician.

For details on what Medicare covers (and does not) for physicals, see our article on whether Medicare covers annual physicals.

Preventive vs. Diagnostic: A Billing Nuance Worth Knowing

Under the Affordable Care Act, most health plans must cover a defined set of preventive services — including recommended screenings and vaccines — at no out-of-pocket cost when you use an in-network provider. That is why a routine preventive visit and its covered screenings often cost you nothing.

The nuance: if your clinician orders tests to investigate a specific symptom, manages an existing chronic condition, or adds services beyond the covered preventive set during the same visit, those parts can be billed as diagnostic care — which may apply to your deductible, copay, or coinsurance. A surprise bill after a “free” physical usually traces back to this preventive-versus-diagnostic line. To avoid surprises, ask before the visit which services are covered as preventive, and confirm the specifics with your plan — coverage details vary, so always verify with your insurer.

Frequently Asked Questions

How often should I get an annual physical?

Not every organization agrees that a yearly physical is necessary for healthy, low-risk adults; the USPSTF emphasizes specific evidence-based screenings rather than a blanket annual exam. Still, many primary care clinicians recommend a regular visit to monitor vitals, update screenings, and discuss changes — how often is best decided with your own provider based on your age and health.

Is an annual physical covered by insurance?

Under the ACA, most plans cover an in-network annual preventive/wellness visit and recommended screenings at no cost. However, if your provider orders additional tests or addresses a specific complaint during the visit, those services may be billed separately as diagnostic care. Check with your insurer for specifics before your appointment.

What is the difference between an annual physical and a wellness visit?

An annual physical is a hands-on clinical exam where your clinician checks your body systems, may order lab work, and assesses your overall health. A wellness visit, particularly the Medicare Annual Wellness Visit, is a health risk assessment and care-planning session that typically does not include a full physical examination. Many people benefit from both.

What lab work should I ask about at my annual physical?

Depending on your age, sex, and risk factors, common labs your clinician may consider include a complete blood count (CBC), a comprehensive metabolic panel (CMP), a lipid panel, thyroid function (TSH), hemoglobin A1C or fasting glucose, and a urinalysis. Which tests are appropriate — and whether they are covered as preventive — is best decided with your clinician rather than requested off a checklist.

Take Charge of Your Preventive Health

An annual physical exam checklist by age is a roadmap for staying ahead of preventable disease. The screenings may seem routine, but they are among the most powerful tools in modern medicine — catching high blood pressure before a stroke, detecting cancer at a more treatable stage, and identifying diabetes before organ damage begins.

Save this checklist on your phone before your next appointment, bring your medication list and family history, and ask your clinician which screenings and vaccines apply to you this year based on your personal risk. Preventive care is an investment in your future health — one that grows more valuable with every passing year. For more guidance, explore our comprehensive wellness guide.