Medicare Part B covers the annual wellness visit at no cost to you
Yes, Medicare Part B covers an annual wellness visit with your doctor at no charge — you pay nothing out of pocket, not even a copay or deductible. This visit is sometimes called a preventive care visit or annual physical. Your doctor performs a basic health check, reviews your medical history, and screens for common conditions. The visit must happen once every 12 months to be covered.
The coverage applies only if you have been enrolled in Medicare Part B for at least 12 months. If you are new to Medicare, you become may be able to access for this free visit after your first year of coverage begins.
Key Takeaways
- Medicare Part B pays for one annual wellness visit per year with no copay, deductible, or coinsurance.
- The visit must be with a doctor who accepts Medicare, and you must have been enrolled in Part B for at least 12 months.
- The covered visit includes a health history review, physical exam, and screening for certain chronic conditions, but does not include extensive testing or specialist referrals.
- If your doctor orders lab work or imaging during the visit, those services may have separate costs depending on whether they are considered preventive.
- You can schedule this visit once per calendar year; scheduling it twice in one year means you will pay for the second visit.
What is included in the covered annual wellness visit
The annual wellness visit covers a standard set of services. Your doctor will take your blood pressure, check your weight and height, review your complete medical and family history, and ask about your medications and any symptoms you have noticed. The visit also includes screening questions about depression, cognitive function, and your ability to perform daily activities.
Depending on your age and health history, your doctor may order certain preventive screenings — such as a blood pressure check, cholesterol screening, or diabetes screening — as part of the same visit. These screenings are covered at no cost if they are considered routine preventive care for your age group.
The visit does not include treatment for a new illness or injury, extensive diagnostic testing, or specialist referrals. If your doctor finds something during the exam that needs follow-up, that follow-up visit or test may have a separate cost.
What Medicare does not cover during the annual visit
If your doctor diagnoses a new condition during your wellness visit and treats it on the same day, that treatment is not part of the covered wellness visit. For example, if your doctor finds high blood pressure and prescribes medication, the office visit itself is free, but the medication is covered under Part D (prescription drug coverage), not Part B.
Extensive lab work, imaging scans, or specialist consultations ordered during the visit are billed separately. Some preventive tests — such as mammograms, colonoscopies, or bone density scans — are covered at no cost when ordered as preventive care, but others may require you to pay a portion of the cost. Ask your doctor before the visit which tests, if any, they plan to order and whether those tests are covered.
If you see your doctor for a specific complaint or illness on the same day as your wellness visit, Medicare will bill that as a separate sick visit, and you may owe a copay for the sick visit portion.
How to schedule your covered annual wellness visit
Call your doctor's office and ask to schedule your annual wellness visit or preventive care visit. Tell them you have Medicare Part B and want to use your covered annual visit. Your doctor's office should know whether your doctor accepts Medicare and can confirm that the visit will be covered at no cost.
Bring your Medicare card to the appointment. If you have not seen this doctor before, arrive early to complete a new patient form, which usually includes questions about your medical history, medications, and any recent health changes.
You can schedule this visit once per calendar year. If you schedule a second wellness visit in the same calendar year, Medicare will not cover it, and you will receive a bill. If you need to see your doctor for an illness or injury between wellness visits, that visit is a separate sick visit and may have a copay.
When preventive screenings are covered at no cost
Medicare Part B covers certain preventive screenings and tests at no cost when they are ordered as part of routine preventive care. These include blood pressure checks, cholesterol screening, diabetes screening, and colorectal cancer screening (colonoscopy or other approved methods). Mammograms for breast cancer screening and bone density scans for osteoporosis are also covered.
The coverage depends on your age and health history. For example, a colonoscopy is typically covered once every 10 years starting at age 50, but if you have risk factors for colorectal cancer, your doctor may recommend it more often. Ask your doctor which screenings are recommended for you and whether they will be covered during your wellness visit or scheduled separately.
If a screening test finds something abnormal and your doctor needs to do a follow-up biopsy or additional imaging, that follow-up may have a cost. The initial screening is free, but diagnostic testing to investigate an abnormal result is usually billed separately.
What to do if you receive a bill for your wellness visit
If you receive a bill after your annual wellness visit, contact your doctor's office first. The office may have billed the visit incorrectly, or they may have coded it as a sick visit instead of a wellness visit by mistake. Ask them to review the claim and resubmit it to Medicare with the correct code.
If the office confirms the bill is correct, contact Medicare directly. You can call 1-800-MEDICARE (1-800-633-4227) and ask them to review the claim. Medicare can tell you whether the visit should have been covered and can help resolve billing disputes. Keep a copy of your bill and your Medicare card when you call.
Do not ignore a bill. If you believe the visit should have been covered, report it to Medicare so they can investigate. If you owe money and cannot pay, ask your doctor's office about payment plans.
Frequently Asked Questions
Can I have my annual wellness visit and a sick visit on the same day?
Yes, but Medicare will bill them separately. The wellness visit is free, but if your doctor also treats you for a new illness or injury during the same appointment, that treatment portion is billed as a sick visit and you may owe a copay. Tell your doctor at the start of the visit if you have a specific health concern so they can code the visit correctly.
What if I have not seen a doctor in several years?
You can still schedule your annual wellness visit. Your doctor will take a complete medical history, which may take longer than a routine visit. The visit is still covered at no cost. If your doctor finds something that needs treatment or follow-up, that is a separate visit or service with its own cost.
Does my Medigap or Medicare Advantage plan affect the cost of my wellness visit?
No. Whether you have Original Medicare with a Medigap plan or a Medicare Advantage plan, the annual wellness visit is covered at no cost to you. Medigap plans do not charge a copay for covered services, and Medicare Advantage plans must cover the wellness visit with no copay. Check your plan documents if you are unsure.
Can I schedule my wellness visit with a nurse practitioner or physician assistant instead of a doctor?
Yes. Medicare covers the annual wellness visit whether it is performed by a doctor, nurse practitioner, or physician assistant, as long as they accept Medicare. Call your healthcare provider's office to confirm they offer wellness visits and that the provider you want to see is available.
What happens if I miss my annual wellness visit one year?
You can schedule it the following year. There is no penalty for missing a year. Your may be able to access for the free annual visit resets each calendar year, so you can have one covered visit per year whenever you choose to schedule it.