If you’ve recently enrolled in Medicare, you might assume that your yearly physical is still part of the package. After all, it’s something you’ve probably scheduled for decades without thinking twice. But here’s the surprise: Medicare doesn’t cover an annual physical in the way most people expect.
That’s where the confusion begins. Instead of the traditional head-to-toe exam, Medicare Part B offers a different kind of benefit—one designed less around diagnosing problems in the moment and more around preventing them in the future.
What Medicare Does Cover: The Annual Wellness Visit
Medicare Part B doesn’t include a traditional physical exam. Instead, it offers something called an Annual Wellness Visit.
This visit is available once every 12 months, starting in your second year of Medicare Part B. (Your first year includes the “Welcome to Medicare” visit, which is similar.)
The Annual Wellness Visit is not a full check-up. It’s a planning visit focused on prevention and early detection. It helps you and your doctor create a strategy to manage your health moving forward.
Best of all, this visit is completely covered by Medicare—with no copay or deductible—as long as your provider accepts Medicare assignment.
What’s Included in an Annual Wellness Visit?
Even though it’s not a full physical, the Annual Wellness Visit still offers important benefits. During the visit, your doctor will usually:
- Review your medical and family history
- Discuss your current medications
- Update your list of doctors and specialists
- Check your blood pressure, weight, and body mass index (BMI)
- Screen for memory issues or depression
- Create or update your Personalized Prevention Plan
This is your chance to talk with your doctor about what to expect in the year ahead—like when to schedule important screenings or vaccinations.
What’s Not Included?
The Annual Wellness Visit does not include:
- A full hands-on physical exam (checking your heart, lungs, reflexes, etc.)
- Routine blood tests or lab work, unless ordered for a medical reason
- Evaluation or treatment of new or existing health problems
If you need those services, they must be scheduled separately or billed in a different way. That could mean extra costs depending on your plan.
What About the Traditional Physical?
A traditional physical exam is a full check-up that includes lab work, screening tests, and a detailed exam of your body systems. This is the kind of appointment many people are used to having once a year.
However, Medicare does not cover this kind of routine physical unless it’s medically necessary and tied to a specific diagnosis. If it’s just for general health maintenance, you could be responsible for the entire cost out of pocket.
Why the Annual Wellness Visit Still Matters
Even though it’s not a physical exam, the Annual Wellness Visit is a valuable benefit. It helps you stay focused on prevention, track your health over time, and stay ahead of potential problems.
Think of it as a strategy session with your doctor. You’ll review what’s going well, talk about what needs attention, and make a plan for the year ahead.
At Medicare School, we strongly encourage enrollees to take advantage of this visit each year. It’s one of the easiest ways to stay proactive and get the most out of your Medicare coverage.
You Don’t Have to Figure This Out Alone
Medicare can be confusing, especially when it comes to what is—and isn’t—covered. If you’re unsure about your benefits, or want to avoid surprise bills, we’re here to help.
Book a free call with one of our licensed Medicare Guides, or give us a call at 800-864-8890. We’ll walk you through your coverage, answer your questions, and help you feel more confident about your next doctor visit.
You worked hard for your Medicare. Let’s make sure you’re using it to its fullest.