Medicare Part B covers one preventive physical exam per year at no cost to you

Yes, Medicare Part B pays for an annual wellness visit — sometimes called a preventive physical or annual physical exam — with no copay, coinsurance, or deductible if you see a doctor who accepts Medicare. This visit is different from a routine checkup you might schedule when you feel sick. It is specifically designed to check your overall health, update your medical history, and spot potential problems early.

The coverage applies whether you see your primary care doctor, a nurse practitioner, or a physician assistant, as long as they accept Medicare assignment. You must have been enrolled in Medicare Part B for at least 12 months to use this benefit, though most people who have had Medicare for any length of time meet this requirement.

Key Takeaways

  • Medicare Part B covers one preventive physical per calendar year with zero out-of-pocket cost if your provider accepts Medicare.
  • The visit must be billed as a "Welcome to Medicare" exam (if you are new to Medicare) or an "Annual Wellness Visit" to receive full coverage.
  • Additional tests or services ordered during the visit — such as lab work, imaging, or specialist referrals — may have separate costs depending on whether they are preventive or diagnostic.
  • If you have a Medigap or Medicare Advantage plan, your coverage may differ, so check your plan documents or call your plan before your appointment.

What is included in a Medicare-covered annual physical

A Medicare-covered preventive physical typically includes a review of your medical and family history, measurement of your height, weight, and blood pressure, and a basic physical examination. Your doctor will also assess your risk for depression, cognitive impairment, and functional decline — especially important as you age.

The visit often includes a discussion of preventive services you may need based on your age and health history, such as cancer screenings, bone density tests, or vaccinations. Your doctor may also review your current medications and discuss lifestyle changes like diet, exercise, and smoking cessation.

However, the visit does not automatically include every test or procedure you might want. If your doctor orders lab work, an EKG, imaging, or refers you to a specialist during the visit, those services are billed separately and may have out-of-pocket costs.

The difference between "Welcome to Medicare" and "Annual Wellness Visit"

Medicare offers two types of preventive physical exams, and the one you receive depends on your situation. If you are newly enrolled in Medicare Part B, you are may have access to to a Welcome to Medicare preventive visit within your first 12 months of coverage. This visit is more comprehensive and includes a complete health assessment, review of your medical history, and a personalized prevention plan.

After that first year, you receive an Annual Wellness Visit each calendar year. This visit is shorter and focuses on updating your health status, reviewing your prevention plan from the previous year, and identifying any new health concerns. Both are covered at no cost, but only if your provider bills them with the correct code — so it is worth confirming with your doctor's office before your appointment that they are scheduling a preventive visit, not a standard office visit.

Tests and services that may cost extra

During your annual physical, your doctor may order tests or services that are not included in the preventive visit itself. The cost depends on whether Medicare classifies each service as preventive or diagnostic.

Preventive services covered at no cost include certain screenings based on your age and risk factors — such as colorectal cancer screening, mammography, prostate cancer screening, and bone density testing. Medicare also covers routine vaccinations like the flu shot, pneumonia vaccine, and shingles vaccine.

Diagnostic services that may have a cost include lab work ordered because your doctor suspects a problem (rather than as routine screening), EKGs, imaging, or specialist visits. If your doctor finds something during your physical that needs further investigation, those follow-up services typically fall under your regular Medicare benefits, which means you may owe a copay or coinsurance.

Before your appointment, ask your doctor's office which services they plan to provide during the visit and whether any additional tests are expected. This helps you understand what will be covered and what might cost you money.

How Medicare Advantage and Medigap plans affect your coverage

If you have a Medicare Advantage plan (Part C), your coverage for the annual physical may differ from Original Medicare. Most Medicare Advantage plans cover the preventive physical at no cost, but some may have different rules about which doctors you can see or which additional services are included. Check your plan documents or call your plan's customer service before scheduling to confirm your coverage.

If you have a Medigap policy (supplemental insurance), it typically covers the copay or coinsurance you would owe under Original Medicare. Since the preventive physical itself has no copay under Original Medicare, Medigap does not add extra coverage for the visit itself — but it may cover costs for any additional tests or services ordered during the visit.

How to schedule your Medicare-covered physical

Call your doctor's office and specifically ask to schedule a preventive physical or annual wellness visit covered by Medicare. Tell them you have Medicare Part B and want to use your annual preventive benefit. This ensures they bill the visit correctly so you pay nothing.

Bring your Medicare card and any other insurance cards you carry. If this is your first year on Medicare, mention that so they schedule a Welcome to Medicare visit instead of a standard Annual Wellness Visit. If you do not have a regular doctor, you can find Medicare-accepting providers through the Medicare.gov provider search tool or by calling 1-800-MEDICARE.

Some community health centers and urgent care clinics also offer preventive physicals covered by Medicare. If you prefer to see a nurse practitioner or physician assistant instead of a doctor, confirm that your provider accepts Medicare before booking.

What happens if your doctor bills it as a regular office visit instead

Occasionally, a doctor's office may bill your annual physical as a standard office visit rather than a preventive visit. If this happens, you may receive a bill for a copay or coinsurance. If you believe the visit should have been covered as preventive, contact your doctor's office and ask them to rebill it with the correct preventive visit code.

If the office refuses or the bill has already been sent to a collection agency, you can file a complaint with Medicare by calling 1-800-MEDICARE or submitting a complaint through Medicare.gov. Keep copies of your appointment confirmation, any paperwork from the visit, and billing statements to support your case.

Frequently Asked Questions

Can I have more than one preventive physical per year?

Medicare covers one preventive physical per calendar year. If you schedule a second one in the same year, it will be billed as a standard office visit and you will owe a copay. However, if you have a new health concern and need to see your doctor, that visit is separate from your annual preventive benefit.

Do I need a referral to see a doctor for my annual physical?

No. Under Original Medicare, you do not need a referral for a preventive physical. If you have a Medicare Advantage plan, check your plan rules — some require a referral, others do not.

What if I have not seen a doctor in several years?

You can still schedule a preventive physical. If you are new to Medicare, you are may have access to to a Welcome to Medicare visit. If you have been on Medicare for more than a year, you can schedule an Annual Wellness Visit. Both are covered at no cost.

Will my physical include a mental health screening?

Yes. Medicare-covered preventive physicals include screening for depression and cognitive impairment. Your doctor may ask you questions about your mood, memory, or ability to handle daily tasks. These screenings help identify problems early so you can get support if needed.

What if my doctor finds something during the physical that needs treatment?

If your doctor diagnoses a condition or orders follow-up tests, those services are billed separately under your regular Medicare benefits. You may owe a copay or coinsurance for diagnostic tests, specialist visits, or treatment. Ask your doctor to explain what services are needed and what they might cost you.