The question “does Medicare cover annual physicals” is one of the most common — and most misunderstood — topics in Medicare coverage. The short answer is nuanced: Medicare does not cover a traditional head-to-toe annual physical exam in the way most people expect, but it does cover an Annual Wellness Visit (AWV) and a one-time “Welcome to Medicare” preventive visit at no cost to you.
Understanding the difference between these visits can save you hundreds of dollars and prevent unpleasant billing surprises. This article explains exactly what Medicare pays for, what it does not, and how to get the most out of your preventive care benefits.
The Short Answer: Medicare Covers Wellness Visits, Not Traditional Physicals
Medicare Part B covers two specific preventive visits:
- “Welcome to Medicare” Preventive Visit — a one-time visit available within the first 12 months of enrolling in Part B. It includes a review of your medical history, education and counseling about preventive services, and referrals for certain screenings. There is no cost if your doctor accepts Medicare assignment.
- Annual Wellness Visit (AWV) — available once every 12 months after you have had Part B for more than 12 months. This is a health risk assessment and personalized prevention plan, not a physical exam. It is covered at 100 percent with no deductible or copay.
What Medicare does not cover is a routine annual physical — the type of appointment where a doctor performs a comprehensive hands-on examination, checks your reflexes, listens to your heart and lungs, and orders a standard panel of blood work. If your doctor performs this type of exam, you may be billed out of pocket, according to Medicare.gov.
What the Annual Wellness Visit Includes
The Medicare Annual Wellness Visit is a valuable preventive tool, even though it is not a traditional physical. During the AWV, your provider will typically:
- Review your complete medical and family history
- Update a list of current medications and supplements
- Measure your height, weight, blood pressure, and BMI
- Screen for cognitive impairment
- Assess your risk for depression and safety issues (fall risk, home safety)
- Create or update a personalized prevention plan with a screening schedule
- Provide referrals for appropriate preventive screenings and services
The AWV does not usually include a physical examination of your body, blood draws, or diagnostic tests. If your doctor performs any of those services during the same appointment, those additional services may be billed separately under Medicare Part B — subject to the deductible and 20 percent coinsurance. For a full breakdown, see our annual wellness exam checklist.
Preventive Services Medicare Does Cover at No Cost
While a traditional physical is not covered, Medicare Part B covers an extensive list of individual preventive services at no cost when provided by a participating provider. These include:
- Cardiovascular disease screenings (cholesterol, lipid panel) every five years
- Diabetes screenings (fasting glucose, A1C) up to twice per year for those at risk
- Mammograms every 12 months for women 40 and older
- Colorectal cancer screening (colonoscopy, FIT test, Cologuard)
- Lung cancer screening with low-dose CT for eligible adults
- Bone density tests for women 65 and older
- Depression screening annually
- Hepatitis B and C screening
- Flu, pneumonia, COVID-19, hepatitis B, and shingles vaccines
- Prostate cancer screening (PSA test) annually for men 50 and older
The full list is available on CMS.gov. These services are covered when ordered as preventive — meaning there are no symptoms or diagnosed conditions prompting the test. If a test is ordered because of a specific complaint, it becomes a diagnostic service and may incur cost-sharing.
How to Avoid Surprise Bills at Your Medicare Visit
The most common source of unexpected Medicare bills is the blurred line between a wellness visit and a diagnostic visit. Here is how to protect yourself:
Schedule the right type of appointment
When you call to schedule, specifically request an “Annual Wellness Visit” or “AWV.” If you ask for a “physical” or “annual exam,” your doctor’s office may code the visit differently, which can trigger out-of-pocket costs.
Separate preventive and problem visits
If you have a specific health complaint — a new knee pain, a suspicious rash, trouble sleeping — mention it, but understand that addressing it may convert part of the visit from preventive to diagnostic. Some providers handle this by scheduling a follow-up appointment for the medical issue, keeping the AWV purely preventive.
Ask about billing codes before the visit
Call your provider’s billing department and confirm the visit will be billed under the AWV codes (G0438 for initial, G0439 for subsequent). This simple step can prevent confusion down the line.
Medicare Advantage and Annual Physicals
If you have a Medicare Advantage plan (Part C), your coverage may be more generous than Original Medicare. Many Medicare Advantage plans offer a routine annual physical as an extra benefit, beyond the standard AWV. These physicals may include blood work, a hands-on examination, and other services not covered under Original Medicare.
Check your specific plan’s Summary of Benefits or call the plan directly. Coverage varies significantly between carriers and even between plans from the same insurer. The Medicare Plan Finder tool can help you compare options.
What If You Want a Full Physical Exam?
If you want the traditional annual physical — the comprehensive, hands-on exam with lab work — you have several options:
- Pay out of pocket. A routine physical with basic labs typically costs $150 to $400 without insurance coverage, depending on your location and provider.
- Use Medicare Advantage benefits. As noted above, many Part C plans include an annual physical at no additional cost.
- Combine the AWV with targeted preventive services. Schedule your free Annual Wellness Visit and separately order the individual preventive screenings (cholesterol, diabetes, colonoscopy referral) that Medicare already covers at no cost. Together, these provide much of the value of a traditional physical.
For a detailed look at what a standard physical exam includes, read our guide on what an annual physical consists of. You can also use our annual physical exam checklist by age to make sure you are getting the right screenings for your stage of life.
Frequently Asked Questions
Does Medicare Part B cover blood work at an annual visit?
Medicare covers specific preventive blood tests — such as a lipid panel every five years and diabetes screening for at-risk individuals — at no cost. However, a routine comprehensive blood panel ordered as part of an annual physical is generally not covered. If blood work is ordered during your AWV, ask your provider whether each test qualifies as a covered preventive service.
How is the Annual Wellness Visit different from an annual physical?
The AWV is a health risk assessment and care-planning session. It includes height, weight, blood pressure, and cognitive screening but does not typically involve a physical examination of your body. An annual physical includes a hands-on exam — listening to your heart and lungs, checking reflexes, examining your abdomen — along with lab work. Learn more in our article on what a wellness visit is.
Can I get both a wellness visit and a physical in the same year?
Yes. You can schedule a Medicare-covered AWV and also pay out of pocket (or use Medicare Advantage benefits) for a traditional physical in the same calendar year. They are not mutually exclusive.
Does Medicare cover a physical for new enrollees?
Medicare covers the “Welcome to Medicare” preventive visit within the first 12 months of Part B enrollment. This visit is more comprehensive than subsequent AWVs but is still not a full traditional physical. It includes a review of your health history, measurements, vision screening, and education on preventive services.
Make the Most of Your Medicare Preventive Benefits
So, does Medicare cover annual physicals? Not in the traditional sense — but it covers a substantial menu of preventive services that, taken together, provide excellent health monitoring. Schedule your Annual Wellness Visit every year, take advantage of the no-cost screenings available for your age group, and talk to your provider about what additional services might benefit you.
If a full hands-on physical matters to you, look into Medicare Advantage plans that include one, or budget for an out-of-pocket exam. Either way, the worst approach is skipping preventive care altogether. Visit our wellness guide for more strategies to stay on top of your health as you age.