Medicare Annual Wellness Visit vs. Physical Exam: What’s the Difference?

If you're enrolled in Medicare, you may have heard about the Annual Wellness Visit (AWV). Many people assume it's the same as a physical exam, but they are actually quite different—and it's important to understand how they differ, especially when it comes to coverage.

What Is a Medicare Annual Wellness Visit?

The Annual Wellness Visit is a once-a-year appointment covered by Medicare Part B. It’s focused on preventive care and planning, not hands-on examination.

During an AWV, your provider will:

• Review your medical and family history

• Update your list of current medications

• Check height, weight, blood pressure, and other routine measurements

• Assess your risk for depression, falls, and cognitive issues

• Create or update a personalized prevention plan

• Discuss recommended screenings, vaccinations, and lifestyle changes

Covered by Medicare Part B with no cost to you (as long as your provider accepts Medicare and no additional services are performed).

How Is a Physical Exam Different?

A physical exam is a comprehensive, head-to-toe checkup where your doctor:

• Listens to your heart and lungs

• Examines your skin, abdomen, and joints

• Orders lab tests

• Conducts a full physical assessment, even if you're not sick

This type of visit is typically what most people think of as a “yearly checkup.”

Medicare does not cover routine annual physicals. If you choose to have one, you may be responsible for the full cost unless you have other insurance coverage.

Why Doesn’t Medicare Cover a Physical Exam?

Medicare focuses on preventive services that are evidence-based and shown to improve health outcomes. The Annual Wellness Visit was designed to help patients stay healthy by focusing on:

• Early detection of risk factors

• Preventive screenings

• Personalized health planning

A traditional physical exam, which often includes tests or procedures not deemed necessary for asymptomatic individuals, is considered outside the scope of Medicare’s preventive care coverage.

Which One Do You Need?

• Choose the Medicare Annual Wellness Visit if you're due for your yearly Medicare-covered check-in. It’s a great opportunity to create a prevention-focused care plan.

• Choose a physical exam if you want a more comprehensive, hands-on evaluation—and check your insurance plan or ask your provider about costs in advance.

Need help deciding or scheduling your Medicare Annual Wellness Visit? We’re here to guide you through the process and ensure you get the care that’s right for you. Contact our office today to learn more.