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.
This guide organizes the key tests, screenings, and conversations you should expect at your annual physical exam by decade, drawing from recommendations by the U.S. Preventive Services Task Force (USPSTF), the CDC, and other leading health organizations.
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, exercise, 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 for suspicious moles, and assessing your reflexes and neurological function. For a detailed look at what happens during 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.
Ages 18 to 29: Building a Health Baseline
Young adults are establishing the reference points that doctors will track for decades. Key components of the annual physical in your 20s include:
- Blood pressure screening — at least every two years if readings are normal (below 120/80), annually if elevated.
- Cholesterol panel — the USPSTF recommends a baseline lipid panel starting at age 20, with follow-ups every four to six years for low-risk individuals.
- STI screenings — chlamydia and gonorrhea screening annually for sexually active women under 25, and HIV screening at least once for all adults.
- Cervical cancer screening — Pap smear every three years starting at age 21, per the American College of Obstetricians and Gynecologists.
- Depression screening — the USPSTF recommends screening for depression in all adults.
- Immunizations — annual flu vaccine, Tdap booster every 10 years, and any catch-up vaccines.
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 doctor 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 annual physical checklist 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 obese. If you have risk factors, screening may begin earlier.
- Skin checks — while the USPSTF has not issued a universal recommendation, dermatologists suggest annual skin exams for people with fair skin, a history of sunburns, or family history of melanoma.
- Cervical cancer screening update — starting at age 30, women can switch to a Pap smear plus HPV co-test every five years, or a Pap alone every three years.
- Continued cardiovascular monitoring — blood pressure and cholesterol checks remain essential, especially if numbers have been trending upward.
Conversations about stress, sleep quality, 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:
- Mammogram — the USPSTF recommends biennial mammography screening starting at age 40 for women at average risk (updated 2024 guidelines).
- Colorectal cancer screening — the USPSTF recommends starting at age 45 for average-risk adults. Options include colonoscopy every 10 years, FIT test annually, or Cologuard every one to three years.
- Diabetes screening — if not already started, glucose or A1C testing should begin now for overweight adults.
- Eye exam — the American Academy of Ophthalmology recommends a baseline comprehensive eye exam at age 40.
- Cardiovascular risk assessment — your provider may calculate your 10-year ASCVD risk score and discuss statin therapy if appropriate.
This is also when thyroid function testing may be introduced, particularly for women experiencing unexplained weight changes, fatigue, or mood shifts.
Ages 50 to 64: The Critical Screening Decade
More screenings come online in your 50s, and the stakes for catching problems early are higher:
- Lung cancer screening — annual low-dose CT scan 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 age 65, but may start earlier for those with risk factors such as low body weight, smoking, or family history of osteoporosis.
- Abdominal aortic aneurysm screening — one-time ultrasound for men aged 65 to 75 who have ever smoked.
- Hepatitis C screening — one-time screening for all adults aged 18 to 79 (if not previously tested).
- Shingles vaccine — Shingrix is recommended for adults aged 50 and older, given as two doses.
If you have not yet started colorectal cancer screening, it is essential to do so now. The five-year survival rate for colorectal cancer caught at stage I is over 90 percent, according to the American Cancer Society.
Ages 65 and Older: Medicare and Beyond
At 65, most Americans become eligible for Medicare, which changes the landscape of preventive care coverage. Your annual physical exam checklist by age 65-plus includes:
- Medicare Annual Wellness Visit — covered at no cost under Medicare Part B. This is a health risk assessment, not a traditional hands-on physical. Learn more in our annual wellness exam checklist.
- Bone density scan — DEXA scan every two years for women 65 and older and men 70 and older with risk factors.
- Cognitive screening — part of the Medicare Annual Wellness Visit, assessing memory and mental function.
- Fall risk assessment — the USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 and older.
- Pneumococcal vaccine — PCV20 or PCV15 followed by PPSV23 for adults 65 and older who have not been previously vaccinated.
- Continued cancer screenings — colonoscopy, mammography, and lung cancer screening continue based on individual risk and life expectancy discussions with your provider.
For details on what Medicare covers and does not cover for physicals, see our article on whether Medicare covers annual physicals.
Frequently Asked Questions
How often should I get an annual physical?
Despite the name, not every medical 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. However, most primary care physicians recommend at least an annual visit to monitor vitals, update screenings, and discuss health changes — especially after age 40.
Is an annual physical covered by insurance?
Under the Affordable Care Act, most health insurance plans must cover preventive services — including an annual wellness or preventive visit — at no cost when you see an in-network provider. However, if your doctor orders additional tests or addresses a specific medical complaint during the visit, those services may be billed separately. Check with your insurer for specifics.
What is the difference between an annual physical and a wellness visit?
An annual physical is a hands-on clinical exam where your doctor checks your body systems, orders 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 — it typically does not include a full physical examination. Many people benefit from both.
What lab work should I ask for at my annual physical?
Common labs include a complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel, thyroid function (TSH), hemoglobin A1C or fasting glucose, and a urinalysis. Your doctor may also order a vitamin D level, liver enzymes, or PSA test depending on your age, sex, and risk factors.
Take Charge of Your Preventive Health
An annual physical exam checklist by age is your 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 its most treatable stage, and identifying diabetes before organ damage begins.
Print this checklist or save it on your phone before your next appointment. Ask your doctor which screenings apply to you based on your personal and family history. And remember that preventive care is an investment in your future health — one that becomes more valuable with every passing year. For more guidance, explore our comprehensive wellness guide.