Medicare Part B covers the cost of one yearly "Welcome to Medicare" preventive visit in your first year, and annual wellness visits in years after that

Medicare Part B pays for one preventive visit during your first 12 months of coverage. After that first year, you get one wellness visit per calendar year at no cost to you — no copay, no deductible, no coinsurance. The doctor performs a basic physical exam, reviews your medical history, and checks your blood pressure and weight. This is different from a sick visit: you are not there because something hurts or feels wrong.

The catch is that Medicare only covers the visit itself. If your doctor finds something during the exam that needs follow-up — a blood test, an X-ray, a specialist referral — those services are billed separately and may have their own costs. The wellness visit is the door; what happens after you walk through it depends on what the doctor finds.

Key Takeaways

  • Medicare Part B covers one wellness visit per year at no cost, but only if you see a doctor who accepts Medicare.
  • The wellness visit itself is free, but any tests or treatments the doctor orders during that visit are billed separately.
  • You must be enrolled in Medicare Part B to get this coverage; Part A alone does not cover outpatient preventive visits.
  • If you skip your yearly visit, you do not lose the benefit — you can schedule one any time during the calendar year.
  • Some preventive screenings (like mammograms and colonoscopies) are covered separately from the wellness visit and have their own Medicare rules.

What happens during a Medicare wellness visit

The wellness visit is a structured appointment. Your doctor will take your blood pressure, check your weight and height, and ask about your medical history, current medications, and any concerns. They may ask about your mood, memory, or ability to do daily tasks. This information helps them spot early signs of problems like high blood pressure, depression, or cognitive decline.

The visit also includes a review of your preventive screening status — whether you are up to date on mammograms, colonoscopies, bone density scans, or other age-appropriate tests. If you are behind on any of these, your doctor will recommend them. The screenings themselves are covered separately by Medicare, but the recommendation happens during the wellness visit.

You should bring your insurance card, a list of all medications and supplements you take, and a list of any questions or concerns. The visit typically lasts 15 to 30 minutes. If your doctor needs to spend extra time on a specific health problem — treating an infection, for example — that portion may be billed as a separate sick visit with its own copay.

Which doctors accept Medicare for wellness visits

Your primary care doctor, internist, family medicine doctor, or nurse practitioner can perform a Medicare wellness visit. The doctor must accept Medicare assignment, meaning they agree to accept Medicare's payment as full payment for the visit. You can check whether a doctor accepts Medicare by calling their office or searching the Medicare Provider Lookup tool on Medicare.gov.

If your doctor does not accept Medicare assignment, you may still see them, but you could owe the full cost of the visit out of pocket. Some doctors accept Medicare but do not accept assignment for certain services, so it is worth asking directly: "Do you accept Medicare assignment for wellness visits?"

If you are in a Medicare Advantage plan (Part C), your plan may have its own rules about which doctors can provide the wellness visit and whether there are any copays. Check your plan documents or call the plan to confirm.

What costs you money during and after the wellness visit

The wellness visit itself costs nothing if your doctor accepts Medicare assignment. However, anything beyond the basic exam is billed separately. If your doctor orders blood work to check your cholesterol or blood sugar, that lab work has its own cost. If they order an EKG or chest X-ray, that imaging has its own cost. If they refer you to a specialist, that specialist visit is billed separately.

For most preventive tests — like mammograms, colonoscopies, bone density scans, and certain blood tests — Medicare covers the full cost with no copay if they are done for screening purposes (not because you have symptoms). But if a test becomes diagnostic — for example, if a screening mammogram finds something suspicious and you need a follow-up ultrasound — the follow-up may have a copay or coinsurance.

If you have a Medigap or Medicare Advantage plan, your plan may cover some of these additional costs. Check your plan documents to understand your out-of-pocket responsibility before the visit.

How to schedule your yearly wellness visit

Call your doctor's office and ask for a "Medicare wellness visit" or "annual preventive visit." Some offices schedule these automatically; others require you to request one. You can schedule the visit any time during the calendar year — there is no penalty for scheduling in December instead of January, and you do not lose the benefit if you miss a year.

When you call, confirm that the office accepts Medicare and that they will bill the visit as a wellness visit, not a sick visit. This matters because a sick visit has a copay, while a wellness visit does not. If the office is unsure, ask them to check your coverage before your appointment.

Bring your Medicare card and a list of your current medications. If you have specific health concerns you want to discuss, write them down beforehand so you do not forget during the appointment.

Preventive screenings covered separately from the wellness visit

Medicare covers certain preventive tests at no cost, but these are billed separately from the wellness visit. Mammograms for breast cancer screening are covered once per year for women 40 and older. Colonoscopies for colorectal cancer screening are covered once every 10 years (or more often if you have risk factors). Bone density scans are covered once every two years for women 65 and older and men 70 and older.

Blood tests for cholesterol and diabetes screening are covered once per year as part of preventive care. Pap smears for cervical cancer are covered once every three years for women under 65. Prostate cancer screening (PSA test) is covered once per year for men 50 and older.

Your doctor may recommend these tests during your wellness visit, but you do not have to do them all at once. You can schedule them separately, and each one is covered at no cost if it is done for screening purposes and you have not had it recently.

Medicare Advantage plans and wellness visits

If you are enrolled in a Medicare Advantage plan (Part C), you still get a yearly wellness visit at no cost. However, your plan may require you to see a doctor within their network, and there may be different rules about which tests are covered or how much you pay for follow-up care.

Some Medicare Advantage plans offer additional preventive benefits beyond what Original Medicare covers — for example, routine eye exams, dental cleanings, or hearing tests. Check your plan's summary of benefits or call the plan to see what is included. If you switch plans during open enrollment, compare the preventive benefits offered by each plan.

Frequently Asked Questions

Do I have to do all the preventive tests my doctor recommends during the wellness visit?

No. The wellness visit is free, but the tests are separate. You can decline any test and schedule others later. If you want to think about a recommendation, ask your doctor for the reasoning and take time to decide. You can always schedule a screening test in a future month.

What if I see multiple doctors — do I get more than one wellness visit per year?

Medicare covers one wellness visit per calendar year, regardless of how many doctors you see. If two doctors both bill for a wellness visit in the same year, Medicare will pay for one and deny the second. You should designate one doctor as your primary care provider to avoid confusion.

Does Medicare cover a physical exam if I am going back to work or need one for a job?

No. Medicare's wellness visit is for preventive health screening, not for employment, insurance, or other administrative purposes. If you need a physical for work, you will pay out of pocket. Some employers offer these exams at no cost to employees.

Can I get a wellness visit if I just turned 65 and enrolled in Medicare?

Yes. During your first 12 months of Medicare Part B coverage, you get one "Welcome to Medicare" preventive visit at no cost. After that, you get one wellness visit per calendar year. If you enroll mid-year, you can still schedule the first visit before the year ends.

What if my doctor wants to treat something during the wellness visit — do I have to pay for that?

If your doctor finds a problem during the wellness exam and treats it on the same day, that treatment is usually billed as a separate sick visit with its own copay. Ask your doctor beforehand if they plan to treat anything, so you know what to expect cost-wise.