You show up for your free Medicare wellness visit. You expect a real physical. Your doctor asks you a bunch of questions, hands you a screening checklist, and sends you home. No stethoscope. No hands-on exam. You leave a little confused. Then a bill shows up. This is one of the most common Medicare mix-ups I hear about.
The short answer
Medicare does not cover an annual physical. It covers an Annual Wellness Visit, which is a different thing. The Wellness Visit is a planning conversation with your doctor. The physical is a full hands-on exam. If your doctor does exam work outside the Wellness Visit checklist, you may owe for that part.
There are actually three types of preventive checkups Medicare covers, and they get confused all the time. Once you know the difference, you can avoid surprise bills and use the free benefit the right way.
The three Medicare checkups
Medicare has three separate preventive visits. Each one has its own rules.
| Visit | When You Can Get It | Cost |
|---|---|---|
| Welcome to Medicare Visit (IPPE) | Once, in your first 12 months on Part B | Free |
| Annual Wellness Visit (AWV) | Once every 12 months after your first year | Free |
| Traditional annual physical | Not covered by Medicare at all | You pay 100% |
Notice the third row. Medicare does not cover a full physical exam. Ever. Only the first two are free.
The Welcome to Medicare visit
The Welcome to Medicare visit is called the Initial Preventive Physical Exam, or IPPE. You get exactly one of these, ever. It has to happen within your first 12 months of enrolling in Part B.
What the doctor does at the IPPE:
- Reviews your medical and family history
- Reviews your current medications and supplements
- Checks your height, weight, blood pressure, and body mass index
- Simple vision test
- Screens for depression and safety risks like falls
- Talks about advance directives
- Gives you a written plan for screenings and shots you should get
It is free. No deductible, no copay. Nothing counts against your Part B deductible either. Miss the 12 month window and you lose it forever.
The Annual Wellness Visit
Starting your second year on Part B, you can get an Annual Wellness Visit once every 12 months. This is the yearly one people usually mean.
What the AWV covers:
- A written health risk assessment you fill out ahead of time
- Update to your medical history, medications, and providers
- Height, weight, blood pressure, BMI
- Cognitive screening for early signs of dementia
- Depression and safety screening
- A personalized prevention plan and checklist for the next 5 to 10 years
Also free. No deductible, no copay, no coinsurance.
Why it does not feel like a physical
Here is the thing that trips people up. The Wellness Visit is a planning meeting. Your doctor is checking boxes on a list. They are not listening to your heart with a stethoscope, checking your reflexes, or looking at your throat unless you have a symptom.
People walk out saying, "That was not a real physical." They are right. It is not.
Original Medicare simply does not pay for a full hands-on exam every year. Congress designed Medicare that way in the 1960s. Prevention was added over time, but a general physical was never included.
What if I want a real physical?
You have two options. Neither one is bad, but you should know the cost before you sit on the exam table.
Option 1: Pay out of pocket
Most doctors will do a full physical if you ask. You pay the office rate. In most parts of the country, a general physical runs $150 to $300 cash. Ask the front desk for the self-pay price before you book.
Option 2: Bundle it with a problem visit
If you have a real medical concern, your doctor can do a "problem-focused" exam as part of a regular office visit. Medicare pays 80%, you pay 20% after your Part B deductible. This is common. You describe a symptom, the doctor examines you, and they can also do parts of what you would call a physical during the same visit.
Just know: this is billed as an office visit. It is not free.
What happens when a Wellness Visit turns into a problem visit
This is the biggest source of surprise bills. You show up for your free Annual Wellness Visit. You mention your knee has been hurting. The doctor examines the knee, orders an X-ray, and adjusts your blood pressure medication.
Your Wellness Visit is still free. But the knee exam, the X-ray, and the medication change are separate. They get billed as a regular office visit on top of the Wellness Visit.
Two bills on the same day:
- Wellness Visit portion: $0
- Problem-focused visit portion: 20% coinsurance after your Part B deductible
Nothing is wrong with this. Your doctor did the right thing. But if you thought the whole visit was free, that second bill stings.
How to keep your Wellness Visit truly free
If you want a purely free visit, follow these rules:
- Save your medical questions for another appointment. If your shoulder hurts, book a separate visit for that.
- Do not ask for new tests or referrals. Preventive screenings that Medicare already covers are fine. Diagnostic tests are not.
- Confirm the appointment is coded as a Wellness Visit. Ask the front desk what code they will bill. G0402, G0438, or G0439 are the right ones.
- Do not ask the doctor to change or add prescriptions. That turns it into a problem visit.
- Wait 11 full months between AWVs. Do not go early.
What about Medicare Advantage plans?
Medicare Advantage plans must cover the same preventive visits, and most give you extras. Many Advantage plans include an actual free annual physical, dental cleanings, and hearing tests as plan perks.
Check your plan's summary of benefits. Look for phrases like "routine physical exam" or "comprehensive physical." If your plan lists it as a covered benefit, you get a real hands-on physical for free once a year. This is one of the perks that makes Advantage attractive to people who want that yearly checkup.
For a broader list, see our writeup on overlooked Medicare Advantage benefits.
What preventive care is fully free under Original Medicare
The Wellness Visit is just one item on a long list. Original Medicare covers a lot of prevention at zero cost. Some of the most-used ones:
- Flu shot, COVID vaccine, pneumonia shot, shingles shot, hepatitis B vaccine
- Mammogram once a year (women 40+)
- Colonoscopy screening (frequency depends on risk)
- Cardiovascular disease screening every 5 years
- Diabetes screening if you are at risk
- Bone density scan every 2 years
- Cervical, prostate, and lung cancer screening for people at risk
- Obesity counseling
- Alcohol misuse screening and counseling
All 100% free when the provider accepts assignment. See our full list at Medicare preventive services that are 100% free.
Real example
Barbara turned 65 in March 2026. She enrolled in Part B and had her Welcome to Medicare visit in June. It was free.
In June 2027, she goes back for her first Annual Wellness Visit. It is 12 months later, so timing works. She checks all the boxes with the doctor. Free.
In April 2028, only 10 months after her last AWV, she goes back for her yearly checkup. Medicare denies the wellness code because it is too early. The office bills her $340 for a routine visit. Barbara pays because she went early.
Rule to remember: wait 11 full months.
Common mistakes
Calling it a "physical" when you book
The front desk might book you for a real physical if you use that word. Say "Annual Wellness Visit" specifically. That is the code Medicare covers.
Bringing a list of medical problems
The Wellness Visit is for prevention and planning. Bring your questions about symptoms to a separate appointment. Otherwise you owe for those.
Skipping the IPPE
The Welcome to Medicare visit is a use-it-or-lose-it benefit in your first year. Even if you feel great, take it. It sets your baseline.
Assuming free means no bill
The Wellness Visit itself is free. Any lab or imaging your doctor orders during it is not automatically free. Blood work, X-rays, and referrals can still trigger the Part B deductible and 20% coinsurance.
The bottom line
Medicare covers two free preventive checkups: the one-time Welcome to Medicare visit in your first year, and the Annual Wellness Visit every year after. Neither one is a full physical. Both are planning conversations.
A full head-to-toe physical is not covered by Original Medicare. If you want one, you either pay cash, roll it into a problem-focused office visit, or choose a Medicare Advantage plan that includes it as a plan perk.
For more on what Medicare pays for, see what Medicare does not cover for dental, vision, and hearing or the official Medicare.gov Yearly Wellness Visit page. Or book a free 20 minute call and I will walk you through your first year on Medicare in plain English.
Frequently asked questions
Does Medicare cover an annual physical?
No. Medicare covers a yearly Wellness Visit, not a traditional physical. The Wellness Visit is a planning meeting, not a hands-on exam.
What is the Welcome to Medicare visit?
A one-time visit in your first 12 months of Part B. It reviews your health history and creates a prevention plan. Free.
How often can I get a Medicare Annual Wellness Visit?
Once every 12 months, starting your second year on Part B. Must be at least 11 full months after the last one. Otherwise Medicare denies it.
Is the Medicare Wellness Visit really free?
Yes, if the doctor accepts assignment and stays inside the Wellness Visit checklist. Adding problem exams or new prescriptions turns it into a billable office visit.
What does the Medicare Wellness Visit include?
Health risk assessment, history review, medication list, vitals, cognitive screening, depression screening, and a written prevention plan. It is a planning visit, not an exam.