Does Medicare Cover an Annual Physical?

Medicare pays for a yearly wellness visit, not a full physical. If cost has kept you from getting a checkup, this visit is a good place to start. It costs you nothing if your doctor accepts assignment, which means they take Medicare's price as full payment.

You pay nothing for the visit if

• Your doctor or nurse practitioner accepts Medicare assignment.
• It has been 12 months since your last wellness visit or your "Welcome to Medicare" visit.
• The visit stays on prevention, since care for a new problem can cost extra.

Not sure Medicare will pay? Ask anyway, because the office can check. When you call, ask, "Is this my yearly wellness visit? Will any part be billed?" If you would rather have help, a Pair Team advocate can help you book it.

Three kinds of checkups

You don't need the "Welcome to Medicare" visit first. You can start with the yearly visit once you've had Part B for 12 months.

What happens at a yearly wellness visit?

A yearly wellness visit is mostly a conversation, not a routine physical exam, Medicare.gov says. You fill out a short health questionnaire, then your provider will:

• Check your height, weight and blood pressure.
• Go over your health history, your family's history and the medicines you take.
• Do a short memory check for signs of dementia.
• Ask about alcohol and drug use, and review any opioid pain medicine.
• Offer to help you write down your wishes for future care, called an advance directive.
• Give you a written checklist of the screenings and shots you need.

The "Welcome to Medicare" visit is similar, and it adds a simple vision test and a check of your risk for depression.

Why did I get a bill after my wellness visit?

A bill usually means the doctor did more than the wellness visit. You may owe a share if your provider adds tests or services that day, Medicare.gov says.

• You asked about a new problem. If the doctor checks your sore knee, that part is billed as a regular visit. In 2026 you pay 20% after the $283 deductible.
• You got a heart test at your Welcome visit. The deductible and your share apply to that heart test, an electrocardiogram (EKG), Medicare says.
• You asked for a physical. Medicare does not cover it, so you may pay the full amount unless other coverage pays.
• The doctor doesn't accept assignment, so they can charge you more.

Book a separate visit for problems you want treated. If a bill looks wrong, ask the office which part was billed as a regular visit. If Medicare denied something, you can appeal the decision.

What other preventive care does Medicare pay for?

Most screenings and shots cost you $0 if your provider accepts assignment, Medicare.gov says. Your checklist may include:

• A flu shot each flu season, plus pneumococcal, COVID-19 and hepatitis B shots
• Colon cancer screening, including a colonoscopy
• A screening mammogram every 12 months for women 40 and older
• Blood tests for cholesterol, once every 5 years
• Diabetes screening, up to 2 a year if you have a risk like high blood pressure
• A depression screening once a year
• A bone density test every 24 months, if you meet the rules
• Screenings for lung, prostate and cervical cancer, glaucoma, hepatitis C and human immunodeficiency virus (HIV)
• Help to quit smoking, drink less or lose weight

You can see which ones you've had in your online Medicare account.

What if I have a Medicare Advantage plan?

Your plan must cover the wellness visit too, Medicare.gov says, and it may add extras. Call the number on your plan card to ask which doctors to use and if the plan pays for a routine physical.

How to get your wellness visit

1. Call your primary care office. Ask for your "yearly wellness visit" by name, or in your first year, the "Welcome to Medicare" visit.
2. Check the date, because it must be 12 months since your last one.
3. Gather what to bring: a list of every medicine, vitamin and supplement you take, your shot records, and your family's health history.
4. Leave with your checklist. Book the screenings on it before you go.

If you need a doctor, see how to find a doctor who takes Medicare, or call 1-800-MEDICARE (1-800-633-4227).

What a Pair Team advocate does

A wellness visit often leads to more to-dos, like a screening to book or a ride you don't have. This is what we do:

• Book your visit with a doctor who accepts assignment, and help you make your medicine list.
• Set up the screenings on your checklist, and a ride to each one.
• Look over a bill from the visit and call the office if part of it looks wrong.
• Help with what usually comes with it: prescriptions, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Can I have my wellness visit by video?

Yes, you can often have your wellness visit by video from home through December 31, 2027. Medicare lists it as a telehealth service. See what Medicare pays for telehealth.

Does the wellness visit include blood work?

Not every wellness visit includes blood work, but your provider may order tests based on your health. Ask before the blood is drawn if each test counts as a screening.

What happens if the memory check finds a problem?

Medicare covers a separate visit to look more closely at memory and thinking. See what Medicare pays for dementia care.

Does it cost anything to make an advance directive?

Making an advance directive costs nothing as part of your wellness visit, if your provider accepts assignment. At another visit, the deductible and your 20% share apply.

I have Medicaid too. Does that change anything?

Medicaid may change what you pay. Qualified Medicare Beneficiary (QMB) is one of the Medicare Savings Programs. If you have it, providers can't bill you for Medicare copays. Medicaid may also pay for some care Medicare does not. See having Medicare and Medicaid together.

Sources

• Yearly "Wellness" visits, Medicare.gov
• "Welcome to Medicare" preventive visit, Medicare.gov
• What's not covered?, Medicare.gov
• Preventive & screening services, Medicare.gov
• MLN006559 Medicare Preventive Services, CMS
• Advance care planning, Medicare.gov
• Compare Original Medicare and Medicare Advantage, Medicare.gov
• Cardiovascular disease screenings, Medicare.gov
• Diabetes screenings, Medicare.gov
• Mammograms, Medicare.gov
• Bone mass measurements, Medicare.gov
• Flu vaccines, Medicare.gov
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• Qualified Medicare Beneficiary (QMB) Program, CMS
• Medicaid, Medicare.gov