Does Medicare Cover Annual Physicals?

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: Original 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. Importantly, the Annual Wellness Visit is not a physical – it is a prevention-planning conversation, a distinction we return to throughout this article.

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. It is general information, not medical or billing advice – confirm your own coverage with Medicare or your plan.

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 and social history, education and counseling about preventive services, certain measurements and screenings, and referrals for other care. There is generally no cost if your doctor accepts Medicare assignment (some add-on tests may carry cost-sharing).
• 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 when your provider accepts assignment.

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.

Why the Annual Wellness Visit Is Not a Physical

This is the single most important point in this article, so it is worth stating plainly: the Medicare Annual Wellness Visit is not a physical exam. Medicare.gov describes it as “a conversation-based visit with your doctor or other health care provider to create a prevention plan,” and states directly that it “isn’t a routine physical exam.”

In practice, that means the AWV is built around talking, screening questionnaires, and planning – not around a hands-on examination of your body. It is a genuinely valuable benefit, but it is a different thing from the annual physical many people picture. Confusing the two is exactly what leads to surprise bills, because asking for a “physical” can prompt the office to code the visit in a way Medicare does not fully cover.

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 your current medications and supplements (including an opioid and substance-use review)
• Take routine measurements such as height, weight, and blood pressure, and calculate BMI
• Screen for cognitive impairment (signs of dementia or Alzheimer’s)
• Assess your risk for depression and safety issues (fall risk, home safety)
• Create or update a personalized prevention plan with a screening schedule
• Discuss advance care planning if you choose
• Provide referrals for appropriate preventive screenings and services

The AWV does not usually include a hands-on 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 and when you meet the eligibility criteria. These generally include:

• Cardiovascular disease screenings (cholesterol, lipid panel) at set intervals
• Diabetes screenings for those at risk
• Mammograms (screening mammograms once every 12 months for women 40 and older)
• Colorectal cancer screening (colonoscopy, stool-based tests such as FIT or the multi-target stool DNA test)
• Lung cancer screening with low-dose CT for eligible current or former smokers
• Bone density (osteoporosis) tests for those who qualify
• Depression screening annually
• Hepatitis B and C screening for eligible individuals
• Flu, pneumococcal, COVID-19, hepatitis B, and (through Part D) shingles and RSV vaccines
• Prostate cancer screening (PSA test) for eligible men

The full list, with current eligibility and frequency rules, is available on CMS.gov and Medicare.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. Because frequencies and eligibility can change, confirm that a given screening is covered for you before you get it.

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 the initial AWV, G0439 for subsequent AWVs). 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, and extra benefits can change from year to year. The Medicare Plan Finder tool can help you compare options.

What Does Medicare Cost in 2026?

Cost matters when you are weighing out-of-pocket options, so here is the current context – but verify these figures at Medicare.gov, because they change every year and vary by income:

• Standard Part B premium: about $202.90 per month for 2026 per Medicare.gov (higher-income enrollees pay more via IRMAA; some pay less through state assistance).
• Part B annual deductible: $283 for 2026 per Medicare.gov. You pay this before Original Medicare starts to pay for most Part B services. Note this is the deductible, not the premium – the two are sometimes confused.
• Covered preventive visits: The AWV and Welcome to Medicare visit are $0 when your provider accepts assignment and the visit is coded as preventive; the Part B deductible does not apply to the wellness visit itself.

If a service goes beyond preventive care into diagnostic territory, you generally pay the Part B deductible (if not yet met) plus 20 percent coinsurance for the Medicare-approved amount.

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 somewhere in the low hundreds of dollars without insurance coverage, depending on your location, provider, and which labs are included. Ask for a written price estimate in advance, as costs vary widely.
• Use Medicare Advantage benefits. As noted above, many Part C plans include an annual physical at no additional cost – confirm with your plan.
• Combine the AWV with targeted preventive services. Schedule your free Annual Wellness Visit and separately arrange the individual preventive screenings (cholesterol, diabetes, colonoscopy referral) that Medicare already covers at no cost when you qualify. 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 at set intervals and diabetes screening for at-risk individuals – at no cost when you qualify. 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 conversation – Medicare.gov states it “isn’t a routine physical exam.” It includes height, weight, blood pressure, and cognitive screening but does not typically involve a hands-on physical examination of your body. An annual physical includes that 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, certain measurements and screenings, 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. Remember the core distinction: the yearly Annual Wellness Visit is a prevention-planning conversation, not a physical exam. Schedule your AWV 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.

Sources

• Medicare.gov – Yearly “Wellness” visits (confirms the AWV “isn’t a routine physical exam”) and the Welcome to Medicare preventive visit
• Medicare.gov – Medicare costs (standard Part B premium approximately $202.90/month and the $283 annual Part B deductible for 2026; amounts change yearly and vary by income)
• Centers for Medicare & Medicaid Services (CMS) – Medicare preventive services list and Annual Wellness Visit billing codes (G0438 initial, G0439 subsequent)