- The Annual Wellness Visit (AWV) is a $0 preventive-planning visit, not a hands-on physical exam — Medicare states plainly it "isn't a routine physical exam."
- It builds or updates a personalized prevention plan: health risk assessment, history and medication review, a cognitive check, and a written screening schedule.
- The one-time "Welcome to Medicare" visit (IPPE) is available in your first 12 months of Part B; the yearly AWV starts after that, once every 12 months.
- What's NOT included: a head-to-toe exam and most lab tests — if your provider adds those or treats a new problem, it may be billed separately with cost-sharing.
- You pay nothing for the AWV when your provider accepts assignment; ask up front whether anything beyond the AWV will be billed.
- Bring a full medication list, records of screenings done elsewhere, and your top concerns; verify current coverage details at Medicare.gov.
Each year, Medicare beneficiaries are entitled to a no-cost preventive visit designed to catch problems early, update prevention plans, and screen for cognitive and functional changes — yet only about half of eligible enrollees actually use the benefit. The Medicare Annual Wellness Visit (AWV) is not a traditional head-to-toe physical, and that distinction trips up a lot of patients. It is, however, one of the most underused free benefits in the program — and the structure of the visit can meaningfully improve preventive care when used well. This article is general education, not medical advice; confirm current details at Medicare.gov.
What the AWV Actually Is (and Is Not)
The AWV is a planning visit, not a hands-on physical exam. Medicare says so directly on its coverage page: the yearly “Wellness” visit is a conversation-based visit to create a prevention plan, and it “isn’t a routine physical exam.” That single point resolves most of the confusion around this benefit. Created by the Affordable Care Act and rolled out in 2011, the AWV is designed to help your primary care provider develop or update a personalized prevention plan.
According to the Medicare.gov coverage page, the AWV includes a health risk assessment, a review of your medical and family history, routine measurements (height, weight, blood pressure), a review of your current medications, a cognitive assessment for signs of dementia, a review of risk factors and treatment options, an evaluation of substance use disorder risk, and a written screening schedule (a checklist) for upcoming preventive services. An advance care planning conversation and an optional review of physical activity and nutrition can also be part of the visit.
The CMS billing code G0438 is used for the initial AWV (available 12 months after Medicare Part B enrollment), and G0439 is used for each subsequent annual visit. When your provider accepts assignment, Medicare states plainly that “you pay nothing” for the visit, and the Part B deductible does not apply to the AWV itself.
AWV vs Welcome to Medicare Visit vs Annual Physical
These three visits are commonly confused, so it is worth separating them clearly.
- Welcome to Medicare visit (IPPE): the Initial Preventive Physical Examination is a one-time visit available within the first 12 months of Part B enrollment. Despite the word “physical” in its name, it is a preventive-planning visit, not a full exam. You do not have to use it to qualify for the AWV.
- Annual Wellness Visit (AWV): available once every 12 months, starting after you have had Part B for 12 months. This is the recurring benefit most people mean by “wellness visit.”
- Annual physical: the comprehensive head-to-toe exam many patients expect. This is generally not covered by Original Medicare. If your provider performs a full physical or additional services, you may be charged for them.
Many practices schedule a 30–45 minute AWV and offer a separate physical exam or chronic care visit if needed, which may incur cost-sharing. Neither the IPPE nor the AWV is a substitute for a hands-on physical exam — if you want one, ask, and ask what it will cost.
What Happens at the Visit
The AWV typically includes a health risk assessment (HRA), often completed in advance via paper or patient portal. Vital signs (height, weight, blood pressure, BMI) are recorded. The provider reviews medications, allergies, other providers, family history, and chronic conditions. Cognitive function is screened using clinical judgment and, when appropriate, a brief tool; mood and depression may be screened as well.
Functional and safety screening often covers fall risk (using STEADI principles or similar), home safety, hearing, and the ability to perform activities of daily living. The visit ends with a personalized prevention plan — a written checklist listing recommended screenings (such as mammogram, colonoscopy, or lung cancer screening if appropriate), vaccines, and lifestyle counseling. A discussion of advance care planning can also be a covered component of the visit.
What is generally NOT part of the AWV
Because it is a planning visit, the AWV does not ordinarily include a hands-on head-to-toe examination, and it does not automatically include blood work or other lab tests. Medicare notes that additional tests or services beyond the preventive benefit — including a routine physical exam — may leave you responsible for costs if Medicare does not cover them. If your provider orders labs or performs an exam to evaluate a specific symptom, those may be billed separately and subject to coinsurance and the Part B deductible.
Preventive Services Often Coordinated Through the AWV
The AWV is the gateway to many other preventive services covered by Medicare Part B. Depending on your age and risk factors, these can include cardiovascular disease screening, diabetes screening, screening and counseling for obesity, tobacco cessation counseling, alcohol misuse screening, depression screening, lung cancer screening for eligible people with a smoking history, and bone mass measurements. Coverage rules and frequency limits apply to each, so your provider will map them to your personal schedule.
Many recommended vaccines are also covered without cost-sharing, including influenza, pneumococcal, and shingles (Shingrix) vaccines. Our guides to the shingles vaccine and the pneumonia vaccine for seniors cover these in more detail. Confirm what applies to you at Medicare.gov, as coverage details can change year to year.
How to Prepare
The visit is more useful if you arrive prepared. Bring a complete medication list including over-the-counter drugs, supplements, herbal products, and as-needed medications, with doses and frequencies. Bring a list of all your current providers and any specialist appointments. Bring documentation of any preventive services done elsewhere (mammogram, colonoscopy, immunizations) so your record is accurate.
Prepare a list of questions and concerns. Common topics worth raising: memory or attention concerns, falls or near-falls, sleep quality, mood, urinary symptoms, hearing or vision changes, isolation, and caregiving stress. Consider bringing or updating your advance directive — Medicare covers the conversation, and many practices use the visit to ensure documents are on file. For more on these documents, see our advance directives guide.
Common Pitfalls and Surprise Bills
The most common surprise: a patient comes in for the AWV but raises a new symptom (chest pain, a joint problem, an abnormal lab) and the provider performs an additional evaluation. This may be billed as a separate problem-focused visit (an office/E-M service) with cost-sharing applied. CMS allows this — the AWV is preventive planning, not a sick visit — but it helps to ask up front whether your provider plans to bill anything beyond the AWV.
Some preventive services may also be billed as diagnostic if you have specific symptoms. A screening colonoscopy is generally covered; the same colonoscopy ordered to evaluate symptoms may carry cost-sharing. The Medicare Learning Network’s preventive-services materials from CMS detail what is covered and under what conditions. When in doubt, call your provider’s billing office before the appointment.
2026 Part B Context
The AWV itself costs you nothing when your provider accepts assignment, but it is worth understanding the Part B numbers that govern everything else. For 2026, the standard Medicare Part B premium is $202.90 per month (higher for people with higher incomes), and the annual Part B deductible is $283. Those figures matter because any services layered onto your AWV — labs, an exam for a new problem, or diagnostic tests — flow through Part B cost-sharing once the deductible applies, typically leaving you responsible for 20% coinsurance for covered services. The AWV stays free; the add-ons may not. Verify the current year’s amounts at Medicare.gov, as premiums and deductibles are set annually.
If You Have Medicare Advantage
Medicare Advantage plans must cover at least the same preventive services as Original Medicare, including the AWV at no cost. Many plans add extra benefits — fitness memberships, vision exams, dental cleanings, hearing aids, or transportation. Your plan may also use a separate in-home health risk assessment or wellness visit through a contracted vendor; those can count, but the in-office AWV with your own primary care provider is generally more valuable because your provider can act on the findings and integrate them with your ongoing care.
Medicare Supplement (Medigap) holders pay the same as Original Medicare beneficiaries for the AWV — nothing — and any covered downstream services are typically picked up by their Medigap plan when billed under Part B. Discuss specifics with your provider’s billing office before the appointment.
Frequency and Eligibility
You are eligible for one AWV every 12 months. Many practices schedule the visit in roughly the same month each year to keep the timing simple. You do not need to use the Welcome to Medicare visit before scheduling your first AWV — but if you are within the first 12 months of Part B, the IPPE (not the AWV) is the visit available to you.
Spouses can each have their own AWV; Medicare is individual. If you missed a year, you do not lose the benefit — schedule whenever you are due. Many primary care offices send proactive reminders, but if yours does not, request an AWV by name when you call, and confirm it will be billed as a wellness visit.
When to See a Doctor
The AWV is preventive — it is not where you address acute problems. New chest pain, shortness of breath, sudden vision changes, a fall with injury, severe abdominal pain, fever, or any concerning symptom warrants a separate same-day visit, urgent care, or ER evaluation rather than waiting for an annual visit. For ongoing optimization, the AWV pairs well with our healthy aging guide and our broader medical conditions library.
When to seek emergency care: Call 911 or go to the nearest emergency room for chest pain or pressure, sudden severe headache, slurred speech or facial droop, sudden weakness or numbness, severe shortness of breath, a fall with head injury (especially while taking blood thinners), or new confusion. Do not delay emergency care to keep an upcoming AWV appointment.
Frequently Asked Questions
Is the Medicare Annual Wellness Visit really free?
Yes, when it is billed as G0438 or G0439 by a provider who accepts assignment. There is no copay, no coinsurance, and the Part B deductible does not apply to the visit itself. Additional services performed at the same visit — treatment of a new symptom, certain tests or procedures — may have cost-sharing.
Is the Annual Wellness Visit a physical exam?
No. Medicare states clearly that the yearly wellness visit “isn’t a routine physical exam.” It is a conversation-based prevention-planning visit that produces a personalized screening schedule. If you want a hands-on head-to-toe physical, ask your provider — that is a separate service that Original Medicare generally does not cover.
Can my AWV be done by telehealth?
In many cases yes, depending on current Medicare telehealth rules and your provider’s setup. Telehealth flexibilities have changed several times in recent years, so confirm current availability with your provider and at Medicare.gov before assuming a video or phone visit will be covered as an AWV.
How is the AWV different from an annual physical?
The AWV is a preventive planning visit covering risk assessment, screenings, and a personalized prevention schedule — with no hands-on exam required. A traditional physical includes a head-to-toe examination, which is generally not covered by Original Medicare unless tied to a specific medical issue.
What if I have a Medicare Advantage in-home health assessment?
That counts as a wellness assessment under your plan, but it does not replace the value of an AWV with your own primary care provider, who can act on the information immediately and integrate it with your ongoing care.
The Bottom Line
The Medicare Annual Wellness Visit is one of the most underused free benefits in Original Medicare. Used well, it helps catch cognitive decline, mood changes, and fall risk early and keeps you current on preventive screenings and vaccines. Remember what it is and is not: a $0 planning visit, not a hands-on physical. Bring a medication list, records of screenings done elsewhere, and your top concerns; schedule one every 12 months; and verify current coverage at Medicare.gov. For more on prevention, our fall prevention guide covers one of the AWV’s most consequential screening domains.
This article is general education, not medical or benefits advice, and it does not replace guidance from Medicare or your provider. Coverage rules, codes, premiums, and deductibles change yearly. Confirm what applies to your situation at Medicare.gov or by calling 1-800-MEDICARE, and talk with your provider’s billing office before your appointment if you have cost questions.
Sources
- Medicare.gov — “Yearly ‘Wellness’ visits” coverage page (the visit “isn’t a routine physical exam”; you pay nothing when the provider accepts assignment)
- Medicare.gov — Medicare costs (2026 Part B standard premium $202.90; 2026 Part B deductible $283)
- Centers for Medicare & Medicaid Services (CMS) — Medicare Learning Network preventive-services materials; AWV codes G0438 and G0439; “Welcome to Medicare” Initial Preventive Physical Examination (IPPE)