What the Medicare Wellness Exam Covers

The Annual Wellness Visit is a free preventive care appointment covered by Medicare Part B once every 12 months. It is not a full physical exam — it focuses on screening, planning, and prevention rather than diagnosing or treating illness. During this visit, your doctor reviews your health history, checks your weight and blood pressure, and talks with you about staying healthy and preventing disease.

The visit includes a personalized prevention plan based on your age, health status, and risk factors. Your doctor may recommend screenings, vaccinations, or lifestyle changes. If the visit uncovers a new health problem that needs treatment, that treatment is a separate visit and may have a copay — the wellness visit itself is free.

You can have this visit with your primary care doctor, a nurse practitioner, or a physician assistant. It typically lasts 15 to 30 minutes, though it can take longer if you have complex health needs or many questions.

Key Takeaways

  • Medicare Part B covers one free Annual Wellness Visit per year, with no copay or deductible.
  • The visit focuses on prevention and health planning, not on treating existing conditions or new complaints.
  • Your doctor creates a personalized prevention plan that may include screenings, vaccines, or lifestyle information.
  • If a new health problem is found during the visit, treatment for that problem is a separate appointment with its own costs.
  • You can schedule the wellness visit with your primary care doctor, nurse practitioner, or physician assistant.

What Happens During Your Wellness Visit

Your doctor will start by reviewing your complete medical history, including past illnesses, surgeries, medications, and family health patterns. They will ask about your living situation, whether you feel safe at home, and whether you have support from family or friends. These questions help identify risks that go beyond typical medical problems — isolation, falls, or caregiver stress, for example.

Next, your doctor takes basic measurements: weight, height, and blood pressure. They may calculate your body mass index (BMI) and assess your ability to walk and balance. These straightforward checks can reveal early signs of problems like heart disease, diabetes, or fall risk.

Your doctor will then discuss which screenings make sense for you based on your age and health. Common screenings include blood pressure monitoring, cholesterol testing, diabetes screening, and cancer screenings (colorectal, breast, or prostate, depending on your age and sex). They may also talk about bone density screening, depression screening, or cognitive screening if you are at risk.

At the end of the visit, your doctor gives you a written summary of the visit and your personalized prevention plan. This document lists any screenings or vaccines recommended, lifestyle changes to consider, and follow-up steps. Keep this summary — it helps you and any other doctors you see understand what was discussed.

Who Should Schedule a Wellness Visit and When

If you have Medicare Part B, you are covered for this visit. You do not need to be in Original Medicare — if you have a Medicare Advantage plan, your plan must also cover the Annual Wellness Visit at no cost to you. Check your plan documents or call your plan to confirm the visit is covered.

You can schedule the visit anytime during the calendar year. Many people schedule it during a month when they have fewer other appointments, or at a time that works with their doctor's schedule. There is no penalty for scheduling it early or late in the year — what matters is that you have one visit per 12-month period.

If you are new to Medicare, you are also covered for a one-time Welcome to Medicare preventive visit during your first year of coverage. This visit is similar to the Annual Wellness Visit but happens only once. After that, you move to the yearly Annual Wellness Visit schedule.

How to Schedule Your Wellness Visit

Call your doctor's office and ask to schedule an Annual Wellness Visit (some offices call it a preventive visit or wellness exam). Tell them you have Medicare and want to use your free annual visit. The office staff will confirm that Medicare covers the visit and may ask you to come in a few minutes early to update your health history form.

Bring your Medicare card and any insurance cards you have. If you have seen other doctors since your last wellness visit, bring a list of any new medications or health changes. If you have questions about your health or concerns you want to discuss, write them down beforehand so you do not forget during the appointment.

If you do not have a primary care doctor, you can schedule the visit with any doctor who accepts Medicare. Community health centers and federally may have access to health centers (FQHCs) also offer wellness visits and can help you find a regular doctor if you need one.

What Is Not Covered During the Wellness Visit

The wellness visit is designed for prevention and planning, not for treating existing health problems. If you come in with a sore throat, chest pain, or a new symptom, your doctor may address it — but that becomes a separate "sick visit" or problem-focused visit, which may have a copay or deductible.

Similarly, if your doctor finds something during the wellness visit that needs treatment — such as high blood pressure or abnormal lab results — the follow-up care and any medications are separate from the wellness visit and may have costs. The wellness visit itself is free, but managing a new diagnosis is not.

Routine lab work ordered during the wellness visit (such as cholesterol or blood sugar testing) is usually covered by Medicare as a preventive service, but some labs may have costs depending on your plan. Ask your doctor which labs are covered before you leave the office.

How the Wellness Visit Fits Into Your Overall Care

The Annual Wellness Visit is one piece of preventive care. It is meant to catch problems early and help you stay as healthy as possible. The screenings and vaccines recommended during your visit may happen at the same appointment or at separate visits — your doctor will explain the plan.

If you have chronic conditions like diabetes or heart disease, the wellness visit is separate from your regular visits to manage those conditions. You may see your doctor multiple times a year for disease management, and the wellness visit is an additional appointment focused on prevention and overall health planning.

Keep the written prevention plan your doctor gives you and share it with any other doctors you see. This helps all your doctors understand what screenings you have had, what is recommended next, and what you are working on to stay healthy.

Frequently Asked Questions

Does the wellness visit cost anything if I have Medicare?

No. Medicare Part B covers the Annual Wellness Visit with no copay, coinsurance, or deductible. You pay nothing for the visit itself. If your doctor orders lab work or finds a problem that needs treatment, those services may have costs.

Can I use my wellness visit to talk about a health problem I have been having?

The wellness visit is designed for prevention and planning, not for treating specific complaints. If you have a new symptom or ongoing problem, mention it to your doctor, but they may schedule a separate sick visit to address it properly. That visit may have a copay.

What if I have a Medicare Advantage plan instead of Original Medicare?

Medicare Advantage plans must cover the Annual Wellness Visit at no cost, just like Original Medicare. Call your plan or check your plan documents to confirm coverage and to find out which doctors in your plan offer the visit.

How often can I have a wellness visit?

You are covered for one Annual Wellness Visit per 12-month period. If you have already had a wellness visit this year, you will have to wait until the next calendar year to have another one covered for free.

What should I bring to my wellness visit?

Bring your Medicare card and any other insurance cards. Bring a list of all medications you take, including over-the-counter drugs and supplements. If you have questions or health concerns, write them down beforehand so you remember to ask during the visit.