Medicare visits · Insurance and annual physicals

Medicare Annual Wellness Visit vs Annual Physical

Learn the difference between Medicare's Annual Wellness Visit and a routine physical, what each covers, and what you may pay.

Sources checked July 20, 2026Independent clinician review is pending

The direct answer

Medicare covers an Annual Wellness Visit once every 12 months to develop or update a personalized prevention plan. It is not the same as a routine physical exam, which Medicare does not generally cover.

What the Annual Wellness Visit includes

The Medicare Annual Wellness Visit is a prevention-focused appointment. Your clinician reviews your medical and family history, measures height, weight, blood pressure, and other routine measurements, and assesses cognitive and functional status. The visit produces a personalized prevention plan and a screening schedule tailored to your health risks.

It is generally covered once every 12 months after the first 12 months of Medicare Part B enrollment, when assignment is accepted. You do not need to have a specific complaint to qualify.

Health risk assessment and medical history review
Routine measurements such as blood pressure and weight
Cognitive and functional screening
Personalized prevention plan and screening schedule

What a traditional physical includes

A traditional head-to-toe physical exam involves a more comprehensive evaluation of the body, including examination of the heart, lungs, abdomen, skin, and other systems. It may include diagnostic tests or management of chronic conditions. Medicare generally does not cover this type of routine physical.

Many patients use the terms interchangeably, but Medicare does not. If you ask for a physical, you may receive one, but you may also receive a bill.

Why the distinction matters for your wallet

If you schedule a routine physical on Medicare, you may be billed for the full cost because it is not a covered benefit. If you schedule an Annual Wellness Visit but the clinician performs a physical exam or manages chronic diseases, those portions may be billed separately and may involve cost sharing.

The words you use when booking matter. Ask for the Annual Wellness Visit by name if that is what you want. Also confirm that the provider accepts Medicare assignment, which limits what you can be charged for the covered service.

What this does not mean

The Annual Wellness Visit does not mean you can never receive a physical exam. It means Medicare will not pay for a routine comprehensive physical as a preventive benefit. Medically necessary evaluation of symptoms or conditions may still be covered under other rules. The visit also does not replace specialty care or management of complex chronic disease.

How to schedule the right visit

Call your clinic and say you want to schedule a Medicare Annual Wellness Visit, not a physical. Ask whether the clinician accepts Medicare assignment, what measurements and assessments will be performed, and whether any chronic-condition management should be scheduled separately.

If you have active medical issues that need attention, consider booking a separate problem-focused visit. That keeps the wellness visit focused on prevention and reduces the chance of an unexpected bill.

Sources checked July 20, 2026. Independent clinician review is pending.

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Frequently asked questions

Is the Medicare Annual Wellness Visit free?

It is generally covered once every 12 months with no cost sharing when your provider accepts Medicare assignment and the visit stays within the covered scope.

Can I get a physical on Medicare?

Medicare does not generally cover a routine annual physical exam. You can still get one, but you will likely pay out of pocket unless other medical necessity rules apply.

What happens at the wellness visit?

The visit focuses on prevention planning, including health risk assessment, measurements, review of risk factors, and a written schedule of recommended screenings.

Can I do both visits in one year?

You can have multiple appointments, but Medicare's Annual Wellness Visit benefit is generally limited to one per 12 months. A separate problem visit or physical would be billed under different rules.

Sources

Sources checked July 20, 2026. Independent clinician review is pending. Educational only; not a diagnosis, medical advice, coverage determination, or substitute for symptom evaluation.