Get in touch
952-999-4049

Need Help

October 13, 2026

Does Medicare Cover an Annual Physical?

Medically reviewed by Dr. Merlin Brown, MD — Board-certified Internist | Updated October 13, 2026

Does Medicare cover annual physical exams? Original Medicare does not pay for a hands-on yearly physical. However, it covers a free welcome to Medicare visit in your first 12 months of Part B, followed by a Medicare annual wellness visit every year after that. Both focus on planning and prevention at $0 cost if your provider accepts Medicare assignment.

What Is a Medicare Wellness Visit, and How Does It Work?

Many people think Medicare pays for a yearly physical. It doesn’t, and that mix-up can lead to an unexpected bill.

The wellness visit is still very common. According to data from CMS (Centers for Medicare & Medicaid Services), among Medicare beneficiaries living in the community in 2022, 60 percent had an annual wellness visit. The confusion is about Medicare physical exam coverage.

Medicare pays for preventive visits that focus on planning. It does not pay for a routine head-to-toe physical. Medicare covers three specific wellness visit types by law, with no copay or deductible for the visit itself when your provider accepts Medicare assignment. Those are the Welcome to Medicare visit, your first annual wellness visit, and every yearly visit after that.

The Welcome to Medicare Visit

The first time you enroll in Medicare Part B, you are eligible for a one-time welcome to Medicare visit. This appointment should be done in your first 12 months of Part B coverage. The main purpose of the visit is to assess your current health status, review your medical history, screen for depression, and develop a plan to prevent future cardiovascular issues. Your doctor will:

Check your height, weight, blood pressure, and vision
Review your medical and family history
Screen for depression
Give you a written list of recommended screenings and vaccines

It is a planning visit, not a full hands-on exam.

The Medicare Annual Wellness Visit (AWV)

If you have been enrolled in Medicare Part B for more than 12 months, you can get a Medicare annual wellness visit every 12 months (or 11 full months after your last AWV). Research published in the Journal of the American Board of Family Medicine (JABFM) shows that physicians performed over 24.7 million AWVs between 2020 and 2022.

What Is Included in a Medicare Wellness Visit?

The visit is a check-in about your overall health, not a physical exam. Here is what is included in a Medicare wellness visit:

A short health questionnaire: You’ll answer questions about your daily routine, eating habits, sleep, stress level, how easily you get around, and whether you worry about falling.
A review of your health history: This covers past surgeries, ongoing conditions, hospital stays, and health problems that run in your family.
A list of your doctors: The office writes down every doctor and specialist you see so your care stays coordinated.
Basic measurements: These include your height, weight, BMI, blood pressure, and pulse.
A memory and mood check: A few simple questions help spot early signs of memory loss or depression.
A safety check: The doctor looks at your balance, your hearing, and how well you manage everyday tasks.
A medicine review: Bring everything you take: prescriptions, over-the-counter medicines, vitamins, and supplements.
A personal prevention plan: You leave with a written checklist for the next 5 to 10 years covering the vaccines, cancer screenings, and bone density scans that suit your age and health.

Medicare Wellness Visit vs. Annual Physical: The Main Differences

Clinical Feature	Medicare Annual Wellness Visit	Traditional Annual Physical
Covered by Original Medicare?	Yes, $0 if your provider accepts Medicare assignment	No, you pay the full price
Hands-on exam?	No (no listening to heart or lungs, no belly check)	Yes, a full check of your body systems
Main goal	Prevention, memory health, and planning	Finding illness or physical problems
Lab tests	Not part of the visit; some are covered separately when ordered for a covered reason	Routine blood panels may not be covered
Your cost	$0 for the visit itself	Self-pay price or private insurance

Which Medicare Visit Is Right for You?

The Welcome to Medicare visit is right for you if you just enrolled in Part B. Book it within the first 12 months, because the free window closes.
The Medicare annual wellness visit is right for you if you have had Part B for more than 12 months and want a prevention plan, even if you feel healthy.
A traditional physical is a good choice if you want a hands-on exam and are willing to pay for it. Some Medicare Advantage plans cover yearly physicals, so call the number on your insurance card to ask.
Look for a different visit if you have a new or ongoing problem, such as knee pain, heartburn, or poor sleep. Medicare advises booking a separate appointment for specific health concerns so the wellness visit stays focused on prevention.

Risks, Costs, and Warning Signs to Know Before Your Appointment

The visit itself is safe. The risks are mostly about money and mix-ups.

Mixing a problem with the wellness visit: If you discuss a new symptom or ask your doctor to manage an existing condition like diabetes, that portion is billed separately as a diagnostic office visit. According to official AMA CPT Modifier -25 Coding Rules, the clinic must add modifier -25 to the problem-oriented portion. The preventive wellness visit stays 100% free ($0 copay), but the diagnostic evaluation and any non-preventive tests are subject to your standard Medicare Part B deductible and 20% coinsurance.
Routine blood test: If your doctor orders a lab test that isn’t tied to a covered reason, Medicare may deny it, and you could owe the lab fee.
Thinking it covers everything: The wellness visit does not include a pelvic exam, prostate exam, or physical organ exam. Don’t skip needed check-ups because you assume it does.
Not asking first: Before you book, ask the office what the visit includes and what could cost extra. Use the exact name, “Welcome to Medicare visit” or “Annual Wellness Visit,“ not “annual physical.”

Don’t wait for a wellness visit if you have chest pain, sudden shortness of breath, sudden weakness or confusion, or any symptom that worries you. Call us or seek urgent care immediately.

How Southdale Physicians Handles Medicare Visits in Edina

At Southdale Physicians, we care for patients ages 16 and older in Edina, MN. Our primary care physicians offer Medicare Wellness Exams to help eligible patients learn about their health risks and build a personal plan for preventive care.

We also offer annual physicals and routine checkups on a fee-for-service basis. We screen for diabetes, high cholesterol, high blood pressure, and certain cancers based on your age, family history, and risk factors. We also offer lab testing, flu shots, and other routine adult vaccines, as well as care for long-term conditions such as diabetes, high blood pressure, and heart disease.

Our Primary Care Services in Edina include:

100% Medicare-covered Annual Wellness Visits
Direct consultations with board-certified internist Dr. Merlin Brown, MD
Convenient on-site laboratory testing and routine adult immunizations (including flu shots)
Chronic disease management for diabetes, hypertension, and heart disease
Unhurried, patient-centered appointment times

Medicare doesn’t cover a routine annual physical, but it does cover a free Welcome to Medicare visit and a yearly wellness visit. Ask for them by name, book new symptoms separately, and confirm extra costs first to avoid surprise bills.