Does Medicare Cover Annual Physicals?

Annual physicals are routine checkups to monitor your overall health. While other health insurance plans commonly cover them, Medicare does not. 

However, Medicare does offer a similar service called an annual wellness visit, and a one-time Welcome to Medicare exam. They both focus on preventive care and keeping track of your health, but they’re not the same as a full physical.

Key Takeaways

• Medicare will not pay the cost of an annual physical and may not pay the full cost of associated diagnostic tests.
• Medicare pays for a Welcome to Medicare exam you receive in the first 12 months after you enroll. After that, it covers an annual wellness exam.
• The Welcome to Medicare visit and the annual wellness visits focus on preventive care to keep you healthy and avoid disease.
• Medicare covers many preventive services, such as flu shots and diabetes screenings.
• Medicare Advantage private health insurance plans could include annual physicals as an extra benefit.

What Is a Welcome to Medicare Visit?

You are eligible for an initial preventive physical exam, also called a Welcome to Medicare visit, when you enroll in Part B for the first time. You can have the exam anytime during your first 12 months with Medicare. The exam is free and you will not be charged a deductible, coinsurance, or copay.

A Welcome to Medicare visit is not a physical exam. Its purpose is to keep you healthy and avoid preventable diseases in the future. Your doctor will gather information about your physical and mental health, evaluate your risks for various diseases, and explain what you can do to maintain or improve your health. Here are examples of information your doctor will collect:

• Your height, weight, and blood pressure
• Your medical history, including previous surgeries, hospitalizations, major illnesses or injuries, allergies, and medications
• Your lifestyle habits, including your diet, exercise, and use of alcohol, tobacco, or illegal drugs
• Your mental health, including any history of depression or other mental disorders
• Your family medical history
• Your ability to perform daily tasks safely, whether you have hearing or vision problems, and your risk of falling

At the end of your exam, your doctor may provide education or counseling about your health. They may also recommend screening tests like a mammogram or routine lab tests, or refer you to a specialist. The cost of health screenings and other medical services you receive after your welcome visit isn’t included in your exam. How much you’ll pay out of pocket depends on the types of tests your doctor orders and whether you’ve purchased additional insurance to go with traditional Medicare.

Tip

While traditional Medicare doesn’t cover annual physical exams, some Medicare Advantage plans do.

What Is an Annual Wellness Visit?

If you’ve had Medicare Part B for more than 12 months you’re eligible for an annual wellness visit. Your doctor may send you a health risk questionnaire to fill out before your appointment date. They will use that data to evaluate your risks of physical diseases, psychological problems like depression, and behavioral issues like excessive alcohol or tobacco use. 

During your visit, your doctor will perform many of the same tasks they completed during your Welcome to Medicare visit, such as measuring your height, weight, and blood pressure, and getting a current list of medications. Your doctor will ask for an update on your recent medical history, including any procedures, illnesses, or injuries you’ve experienced, and medical providers you’ve seen in the last 12 months. They will assess your physical and cognitive health, and create a schedule for preventive tests, such as a glaucoma screening or a bone density measurement. 

Tip

Your first annual wellness visit must occur at least 12 months after your Welcome to Medicare exam. All subsequent visits must be at least 12 months apart. If you missed the Welcome to Medicare exam, you can still take the annual wellness visits.

What Is an Annual Physical Exam?

A routine physical exam includes many of the elements of a wellness exam, including a review of your medical history, an assessment of your risks for preventable diseases, and measurements of your height, weight, and blood pressure.

The main difference is that a physical exam is intended to diagnose disease while a wellness exam focuses on risk assessment, prevention, and health education. Your doctor performs a physical checkup to identify and solve potential problems, such as anemia or a leaky heart valve. Accordingly, an annual physical may include services not provided during a wellness visit, like a head and neck exam, reflex checks, and the collection of urine and blood samples for lab testing.

Why Medicare Does Not Cover the Annual Physical Exam

Medicare doesn’t cover routine physical exams because its rules, set by Title XVIII of the Social Security Act, focus on medically necessary services rather than general checkups. Medicare focuses on maintaining good health by preventing disease. Routine checkups involve physical tests to diagnose diseases.

How Much Does an Annual Physical Cost?

The average cost of an annual check-up without insurance is approximately $200, including some routine tests like blood and urine tests. Because costs vary by state and type of facility, you should check costs in advance. When a provider gives you a price, ask what services are included. For instance, does the price include routine blood and urine tests? Does it include an electrocardiogram? If your doctor recommends tests that aren’t included in the cost of your exam, you may have to pay for them out of pocket.

Does Medicare Cover Annual Physicals for Seniors?

No. Annual physicals aren’t covered by traditional Medicare because they are excluded by the federal law that governs Medicare. All Medicare plans cover a Welcome to Medicare exam during your first 12 months with Medicare and in subsequent years, an annual wellness exam. Unlike a routine physical, which is performed to diagnose disease, an annual wellness visit focuses on screening, prevention, and education.

What Does Medicare Cost?

How much you’ll pay for Medicare depends on where you live and the type of coverage you buy. In 2025, the standard monthly premium for Medicare Part B is $185. You’ll pay an additional monthly premium of $17 (on average) for a Medicare Advantage plan or $64 to $400 (or more) for a Medigap plan. 

If you have traditional Medicare and want prescription drug coverage, you’ll pay an average monthly premium of $40 for a Part D plan. Besides your monthly premiums, you may also have some out-of-pocket expenses for copays, coinsurance, or deductibles. Out-of-pocket costs can vary widely from one plan to another.

When Did Medicare Stop Paying for Annual Physicals?

Medicare has never paid for annual physicals because Title XVIII of the Social Security Act (which authorized Medicare) excludes coverage for routine or annual physical checkups. It also excludes physical exams performed without a specific symptom, patient complaint, or requirement by a third party (such as an insurer). Medicare pays for annual wellness visits, which focus on preventive screening rather than physical tests to diagnose disease.  

What Preventive Care Services are Covered by Medicare?

Medicare Part B covers many types of preventive services that can help you stay healthy by detecting problems early when treatments are most effective. Preventive services include vaccinations, exams, lab tests, screenings, and health monitoring. Your doctor will help you determine which preventive services you need. The out-of-pocket expenses depend on your insurance plan, but some services may be free. Here are examples of preventive services Medicare covers.

• Bone mass measurements
• Depression screenings
• Diabetes screenings
• Mammograms
• Prostate cancer screenings
• Flu vaccines
• COVID-19 vaccines
• Annual wellness visits

The Bottom Line

Medicare doesn’t cover annual physical exams, but it does a Welcome to Medicare exam and annual wellness exams. The Welcome to Medicare visit and annual wellness visits are free, but (depending on your plan) you may have to pay all or part of the cost of diagnostic tests your doctor orders. Medicare enrollees who want an annual physical must either cover the cost out of pocket or enroll in a Medicare Advantage plan that includes this benefit.