Medicare does not cover yearly physicals in the traditional sense. Federal rules exclude routine head-to-toe checkups performed without a specific symptom or complaint. What Medicare does pay for is an Annual Wellness Visit, a $0 planning appointment focused on health risks and prevention, plus a one-time Welcome to Medicare visit for new Part B enrollees. If you want a classic physical with reflex checks, organ palpation, and general lab work ordered “just to see how things look,” you pay the whole bill yourself.
Why the Traditional Physical Isn’t Covered
Federal regulations bar Medicare from paying for routine physical checkups, defined as exams done for any purpose other than diagnosing or treating a specific illness, symptom, or injury.1eCFR. 42 CFR 411.15 – Particular Services Excluded From Coverage The rule carves out specific exceptions for preventive services like mammograms, cancer screenings, and the Annual Wellness Visit. The traditional physical is not on that list.
That means you pay 100% of the cost if you ask for one.2Centers for Medicare & Medicaid Services. Medicare Wellness Visits Depending on where you live and which labs are included, the bill typically runs from around $350 to $500. A Medigap policy won’t rescue you here either. Medigap covers coinsurance on services Medicare already pays for, so it does nothing for a service Medicare excludes outright.
The Annual Wellness Visit Is What You Get Instead
The Annual Wellness Visit is a planning session, not a physical exam. Your provider reviews your health risks, updates your medical history, and builds a personalized prevention plan for the coming years. The required elements are set by federal regulation and are more extensive than most people expect.3eCFR. 42 CFR 410.15 – Annual Wellness Visits Providing Personalized Prevention Plan Services
During the appointment your provider works through a health risk questionnaire covering daily activities, fall risk, home safety, tobacco and alcohol use, nutrition, and exercise. They update your medical and family history, record every doctor and medication you use, and take basic measurements: height, weight, body mass index, and blood pressure. Cognitive impairment screening is mandatory at every visit, and depression screening happens through a standardized questionnaire.4Medicare.gov. Depression Screening You leave with a written schedule of recommended screenings covering the next 5 to 10 years, tailored to your risk profile.
What you won’t get is the hands-on exam most people associate with a physical. No detailed organ palpation, no reflex checks, no comprehensive lab panels ordered just to check baseline health. If that’s what you’re looking for, the wellness visit will disappoint you.
You don’t have to see a physician for this appointment. Medicare allows physician assistants, nurse practitioners, and certified clinical nurse specialists to perform it, as can a team of medical professionals working under a physician’s direct supervision.5Centers for Medicare & Medicaid Services. Annual Wellness Visit Health Risk Assessment
What to Bring
Filling out the health risk assessment before you arrive saves real appointment time. Most offices mail or email the form ahead of the visit. Also bring a current list of every prescription and over-the-counter medication you take with dosages, contact information for all your doctors and specialists, any recent test results from outside your primary care network, and family medical history for conditions like heart disease, diabetes, and cancer. That family history is what drives which screenings land on your prevention schedule.
The Welcome to Medicare Visit: One Chance Only
New Part B enrollees get a one-time introductory appointment called the Initial Preventive Physical Examination, better known as the Welcome to Medicare visit. You have to schedule it within your first 12 months of Part B coverage.6Medicare.gov. “Welcome to Medicare” Preventive Visit The name includes the word “examination,” but Medicare is clear this is not a physical exam either.
The visit covers a review of your medical and social history, depression and substance use screening, an assessment of your functional ability and safety, and a simple vision test.7Centers for Medicare & Medicaid Services. Initial Preventive Physical Exam You also get education about which preventive services to pursue going forward.
Miss the 12-month window and the benefit is gone for good. Medicare pays for exactly one Welcome to Medicare visit per lifetime, and the clock starts when your Part B coverage begins. If you enrolled in Part B within the last year and haven’t scheduled it, do it now.
The 12-Month Rule That Keeps the Visit Free
After your Welcome to Medicare visit, or after your first 12 months of Part B enrollment if you skipped it, you become eligible for the Annual Wellness Visit. At least 12 months must pass between visits.8Medicare.gov. Yearly “Wellness” Visits
This is measured to the day. Scheduling even one day early can get the claim denied and leave you paying full price. If your last wellness visit was March 15, 2025, your next eligible date is March 15, 2026, not sooner. Your provider’s billing office usually checks the date before scheduling, but confirm it yourself.
Telehealth is an option. Medicare’s expanded telehealth flexibilities let many preventive visits happen by video, or even audio-only phone call, from home with no geographic restrictions. Those rules run through December 31, 2027.
How a Free Visit Turns Into a Bill
Both the Annual Wellness Visit and the Welcome to Medicare visit are completely free when your provider accepts Medicare assignment. No deductible, no coinsurance, no copay.2Centers for Medicare & Medicaid Services. Medicare Wellness Visits
The bill appears when the visit slides into treatment. If your provider addresses a new symptom, adjusts medication for a chronic condition, or orders lab work outside the preventive services list, those portions get billed as diagnostic services. That triggers the standard 20% Part B coinsurance after you meet the $283 annual deductible for 2026.9Centers for Medicare & Medicaid Services. MM14279 – Medicare Deductible, Coinsurance and Premium Rates: CY 2026 Update Common culprits include vitamin D tests, comprehensive metabolic panels, and thyroid function tests.
The switch from free to billable can happen mid-appointment without warning. Before any test or service, ask directly whether it will be billed as preventive or diagnostic. Mention a nagging knee pain during your wellness visit and expect a separate charge for that portion.
One useful bundling opportunity: advance care planning conversations about living wills, healthcare proxies, or end-of-life preferences are covered at no cost when they happen during your Annual Wellness Visit and your provider accepts assignment.10Medicare.gov. Advance Care Planning Have that same discussion at a separate appointment and it triggers the Part B deductible and 20% coinsurance.
Medicare Advantage May Cover a Routine Physical
If a traditional physical is important to you, Medicare Advantage (Part C) is where to look. These plans have to cover everything Original Medicare covers, including the Annual Wellness Visit and Welcome to Medicare visit at no cost, but they can add supplemental benefits on top. Some include a routine annual physical as one of those extras.11Medicare.gov. Medicare and You Handbook 2026
Coverage varies significantly by plan. Some offer the physical at no additional cost, others charge a copay, and some limit it to specific network providers. Before choosing or renewing a Medicare Advantage plan, review the Evidence of Coverage document or call the plan directly to confirm what’s included and what you’d owe.