Does Medicare Cover Annual Physicals? 

Getting an annual physical is a great idea for everyone, but even more so for seniors. Yearly visits to your physician can help identify and treat health issues and keep track of your overall well-being. 

During an annual exam, your primary care provider can assess your overall health through blood tests and screenings like those for blood pressure, cholesterol, blood glucose, and osteoporosis. Your physician can also make sure your vaccines are up to date, screen for different types of cancer, make any necessary changes to your medications, keep track of your mental health conditions, and make sure your medical records are up to date. 

Do your Medicare benefits cover annual physicals? 

Original Medicare doesn’t cover annual physicals in the traditional sense. However, it does cover a “Welcome to Medicare” visit when you first enroll in Medicare and an “Annual Wellness Visit”. 

The Welcome to Medicare examination is available one time to all newly enrolled Medicare beneficiaries at any time during their first year of coverage. It includes routine measurements, screening exams, vaccinations, and other preventive services. 

The Annual Wellness Visits are designed to help you and your health care providers develop a personalized wellness plan that can be regularly updated according to your health care needs. 

Medicare Part B (medical insurance) covers 100 percent of the cost for the Welcome to Medicare visit and your Annual Wellness Visit when they are performed by a health care provider or physician who accepts Medicare assignment. And your annual Part B deductible doesn’t apply to these visits either. 

However, if you have additional tests or services that aren’t included in these visits, you may be responsible for a copayment as well as your Part B deductible. Furthermore, if you have additional tests or receive services that aren’t covered by Medicare during the welcome and wellness visits, you may be responsible for 100 percent of the cost. 

What is included in the Medicare Annual Wellness Visit? 

When you go for your Annual Wellness Visit, you first fill out the Health Risk Assessment questionnaire. This helps your doctor develop a prevention plan that can help you stay healthy and is based on your personal information. 

During your annual visit, your health care provider might also do the following:

  • Review your family medical history and make updates to your medical history. 
  • Review current health care providers/physicians
  • Review your prescription medications
  • Take routine measurements like height, weight, blood pressure, and others
  • Give you personalized health advice
  • Provide you with a list of risk factors and possible treatments if applicable
  • Provide you with a schedule for your screening tests provided by preventive services 
  • Make any necessary plans for advanced care 
  • Perform a cognitive assessment 

What does the “Welcome to Medicare” visit entail? 

When you enroll in Medicare, this one-time visit gives your health care provider a chance to get to know you, your medical history, your current health status and to set up a program for your future health care. 

Your doctor may ask you about previous illnesses, medical conditions, surgeries, family medical history, your medications, and your lifestyle habits. Other exam components at this visit can include:

  • Measuring height, weight, blood pressure, body mass index
  • Performing a basic vision test
  • Screening for hearing loss
  • Evaluating your risk for falling and developing depression 

When they have collected this information, they can come up with a health care plan to recommend health screenings, vaccinations, care from specialists, and any other necessary services you may need in the future. 

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