- June 19, 2026
Disclaimer: This article is for educational purposes only and does not replace professional medical advice. If you or someone you love is experiencing a mental health emergency, call 988 (Crisis Lifeline) or 911 immediately.
You call your doctor’s office to schedule your yearly appointment. The receptionist asks whether you want an annual physical or a wellness visit. You pause. Aren’t those the same thing?
They’re not, and the difference matters more than most people realize, especially when the bill arrives.
This guide breaks down exactly what each visit includes, what your insurance is likely to cover, and which one you should actually book. If you’ve ever been confused by these terms, or if you’ve received a bill after a visit you thought was free, this is for you.
Quick Answer
An annual physical exam is a hands-on, head-to-toe medical evaluation. Your provider examines your body, orders labs if needed, reviews your medications, and can address new symptoms or concerns during the same visit. It’s the comprehensive check-in most people picture when they think of a yearly doctor’s appointment.
A wellness visit is a prevention-focused planning session. Your provider reviews your health history, discusses your risk factors, and creates or updates a personalized prevention plan based on guidelines from the U.S. Preventive Services Task Force. There is no mandatory hands-on exam. Blood work is not automatically included.
The key difference is this: a physical evaluates your current health status; a wellness visit plans your future health strategy. Most patients benefit from both, ideally in the same year.
Side-by-Side Comparison
| Annual Physical | Wellness Visit | |
| Primary goal | Evaluate your current physical health | Create or update your prevention plan |
| Hands-on exam? | Yes, head-to-toe | Not required |
| Blood work / labs? | Often ordered | Not automatically included |
| New symptoms discussed? | Yes | May trigger a separate billing code |
| Mental health screening | Often included | Typically included |
| Cognitive assessment | Sometimes | Yes (Medicare AWV) |
| Fall risk screening | Sometimes | Yes (Medicare AWV) |
| Depression screening | May be included | Yes, standard component |
| Vaccine review | Yes | Yes |
| Medicare coverage | Not covered as a routine “free” visit | Free under Medicare Part B once per year |
| ACA commercial plan coverage | Covered as a preventive service (plan-dependent) | Covered as a preventive service |
| Best for | New concerns, chronic conditions, labs, documentation | Screening review, prevention planning, and Medicare patients |
What Is an Annual Physical Exam?
An annual physical is exactly what the name suggests, a real, hands-on medical evaluation of how your body is doing right now.
Your provider does a head-to-toe examination. That means listening to your heart and lungs, checking your abdomen, reviewing your skin, testing reflexes, and going through a full set of vital signs including blood pressure, heart rate, weight, and BMI. It’s the kind of visit where your provider is actively looking for anything that might need attention, not just reviewing paperwork.
It’s also the right visit to bring up symptoms. If you’ve noticed something new, a lump, changes in your digestion, fatigue, chest tightness, anything, the annual physical is where you should raise it.
What Happens at an Annual Physical: Step by Step
- Medical history review — Your provider goes through your personal and family health history, current medications, allergies, and prior surgeries or diagnoses
- Vital signs — Blood pressure, heart rate, respiratory rate, temperature, weight, and BMI
- Head-to-toe physical examination — Heart and lungs, abdomen, skin, lymph nodes, musculoskeletal review, neurological reflexes
- Lab orders — Cholesterol panel, fasting glucose or HbA1c, complete blood count, urinalysis, and other tests as clinically appropriate, all available through WMG’s in-house diagnostic imaging and lab testing
- Vaccine review — Your provider checks what’s current and what you’re due for
- Lifestyle review — Weight, sleep, alcohol use, smoking, stress, and exercise habits
- Symptom and concern discussion — Any new or ongoing health concerns get addressed
- Care planning — Referrals, follow-up appointments, specialist coordination if needed
Who Should Schedule an Annual Physical?
Honestly, everyone. But it’s especially important if you:
- Have a new symptom or concern you’ve been putting off
- Are managing a chronic condition like diabetes, hypertension, or high cholesterol, Ongoing chronic care starts here
- Haven’t had a physical in a year or more
- Need documentation for employment, a school sports physical, an insurance exam, or a new employer wellness program
- Want lab work reviewed alongside a full physical assessment
Men looking for a focused annual exam can also schedule a dedicated men’s annual physical exam at WMG.
What Is a Wellness Visit?
A wellness visit is a prevention-focused planning appointment. The goal isn’t to examine your body right now, it’s to review your health risks, update your prevention plan, and make sure you’re on track with the screenings and vaccines that matter for your age.
Think of it as the strategic side of healthcare. You and your provider sit down, review where things stand, and map out what needs to happen over the next 12 months to keep you healthy.
There’s no mandatory hands-on exam at a wellness visit. Blood work is not automatically ordered. What does happen is a structured conversation guided by a Health Risk Assessment, and that conversation covers more ground than most patients expect.
This is also where your provider should be reviewing your preventive care status, which screenings you’re due for, which vaccines you’re missing, and whether your lifestyle habits are putting you at elevated risk. For a full breakdown of what screenings belong on your list, the preventive care checklist by age is a good companion to this visit.
What Is a Health Risk Assessment?
A Health Risk Assessment (HRA) is a structured set of questions your provider goes through with you at the start of a wellness visit. It covers your medical history, family history, current medications, lifestyle habits, mental health, substance use, fall history, functional status, and more.
It’s not a test. There’s nothing to study or prepare for. It’s a detailed conversation that gives your provider everything they need to build a personalized prevention plan that reflects your actual risk profile, not a generic checklist.
Depression and anxiety and depression screening is standard at a wellness visit. So is a review of your medications, cognitive status, and fall risk.
Medicare Annual Wellness Visit: What You Need to Know
If you’re on Medicare, the Annual Wellness Visit (AWV) is one of the most underused benefits available to you. Medicare covers it completely under Part B, no copay, no deductible, once every 12 months after you’ve been enrolled for at least 12 months.
What it includes, per CMS guidelines:
- Health Risk Assessment questionnaire
- Review of your medical and family history
- Blood pressure, weight, and BMI measurement
- Personalized prevention plan based on USPSTF recommendations
- Cognitive assessment and fall risk screening
- Depression screening
- Review of current prescriptions
- Advance care planning discussion if you choose
What it does not include: a hands-on physical exam. And blood work is not automatically part of the AWV; if your provider orders labs during the same visit, those will be billed separately under Part B as diagnostic services.
Two things Medicare patients often don’t know: the initial AWV (billing code G0438) is different from subsequent annual AWVs (G0439), and since 2020, CMS has allowed Annual Wellness Visits to be conducted via telehealth. WMG offers telehealth appointments, including Sunday video visits, making it easier for Medicare patients to complete their AWV without coming in.
Insurance Coverage: What Each Visit Actually Costs
This is where things get confusing, and where most patients get caught off guard.
The ACA Rule (Non-Medicare Patients)
Under the Affordable Care Act, non-grandfathered commercial health insurance plans are required to cover USPSTF Grade A and B preventive services, including preventive wellness visits, with no cost-sharing.
That means, for most adults with commercial insurance, a preventive wellness visit should cost you nothing out of pocket. An annual physical conducted as a preventive service should also be covered, though specific coverage varies by plan.
Always verify with your insurer before the visit if cost is a concern.
Medicare Coverage
Medicare Part B covers the Annual Wellness Visit free of charge. But here’s what catches many patients by surprise: Medicare does not cover a traditional annual physical the same way. A routine annual physical is not a covered Medicare benefit in the same category as the AWV. If your provider performs a traditional physical, a portion of that visit may be billed differently.
The Unexpected Bill: Explained
This is one of the most common complaints in primary care: a patient schedules what they believe is a free wellness visit, and then receives a bill for a copay or coinsurance.
Here’s what typically happened.
You arrived for your wellness visit. At some point during the appointment, maybe toward the end, you mentioned a new symptom. Maybe a sore knee, unusual fatigue, or some chest tightness you’d been meaning to ask about. Your provider appropriately evaluated that concern.
At that point, two separate medical services occurred in the same appointment: a preventive wellness visit (covered) and a separate Evaluation and Management (E/M) service for the new concern (which may carry a copay). To bill both correctly, the practice uses a modifier code, Modifier-25, which tells your insurer that a separate, significant medical service was provided during the same visit. This is standard, legal, and appropriate medical billing.
How to avoid the surprise: At the start of your wellness visit, tell your provider whether you want to keep it purely preventive or whether you have a health concern to address. If you have both, ask them to note that upfront. You may still be billed for two services, but you’ll know it’s coming.
Billing Heads-Up: Getting a bill after a “free” wellness visit doesn’t mean anyone made an error. It usually means your provider appropriately evaluated a separate concern during the same appointment. When in doubt, call your insurance company and ask them to explain your Explanation of Benefits (EOB) line by line.
Can You Have Both in the Same Appointment?
Yes, in many cases. And for a lot of patients, combining them makes practical sense.
When both services happen in the same visit, both may be billed, the preventive portion covered under your plan, and the E/M portion potentially subject to a copay. That’s not double-billing. It reflects two distinct clinical services performed during the same appointment.
The practical advice: be upfront at the start of the visit. If your goal is both prevention planning and addressing a specific concern, say so. Your provider can document both appropriately, and you’ll go in knowing what to expect on the bill side.
Which One Should You Book?
Here’s a simple way to decide.
Book a wellness visit if:
- You’re due for your annual prevention plan review and have no new symptoms to discuss
- You’re a Medicare patient and haven’t used your Annual Wellness Visit this year
- Your goal is to review your screening status, vaccines, and health risks
- You want a cognitive or fall risk assessment
Book an annual physical if:
- You have a new symptom, concern, or something you’ve been avoiding bringing up
- You need lab work ordered and reviewed alongside a full physical exam
- You’re managing a chronic condition and want a comprehensive status evaluation
- You need documentation — for employment, sports, school, or insurance purposes
- You haven’t had a hands-on exam in over a year
Consider booking both (or asking about combining) if:
- You want comprehensive prevention planning AND have a health concern to discuss
- You’ve been putting off both for too long and want to handle everything at once
- You’re prepared for the possibility that both services may be billed
Quick Tip — What to Say When You Call WMG:
“I’d like to schedule my annual wellness visit.”- “I’d like to schedule an annual physical — I also have a concern I’d like to discuss.”
- “I’m a Medicare patient and want to schedule my Annual Wellness Visit for the year.”
Annual Physicals and Wellness Visits at Windermere Medical Group
Windermere Medical Group offers both annual physicals and wellness visits including Medicare Annual Wellness Visits across all North Georgia locations in Cumming, Canton, Baldwin, Gainesville, Alpharetta, and Lawrenceville.
A few things that make it easier to stay on top of both:
- Same-day appointments available at select locations
- Extended hours Monday through Friday until 6:30 PM
- Sunday video visits — including telehealth options for Medicare AWVs
- In-house lab testing and diagnostic imaging — no separate trip to a lab facility
- 24/7 Nurse Line for questions between visits
- Healow patient portal for online scheduling and records access
WMG’s primary care services also cover everything that comes after the visit chronic disease management, specialist referrals, follow-up care, and long-term health planning so your annual physical or wellness visit isn’t just a once-a-year event but a starting point for ongoing care.
Book your appointment online or call (678) 455-2800 to schedule your annual physical, wellness visit, or both.
FAQs:
Q1. Is a wellness visit the same as an annual physical?
No. They’re related but different. An annual physical includes a hands-on head-to-toe exam and can address new concerns. A wellness visit is a structured prevention planning session without a mandatory physical exam. Most patients benefit from having both each year.
Q2. What is included in an annual physical exam?
A standard annual physical includes a head-to-toe physical examination, vital signs, medical history review, lab orders (cholesterol, blood sugar, and others as needed), vaccine review, lifestyle counseling, and discussion of any symptoms or concerns.
Q3. What is included in a wellness visit?
A wellness visit typically includes a Health Risk Assessment, review of your screening and vaccine history, depression screening, cognitive and fall risk assessment (especially for Medicare patients), medication review, and a personalized prevention plan. Blood work is not automatically included.
Q4. Does Medicare cover annual physicals?
Not as a routine “free” visit the same way it covers the Annual Wellness Visit. Medicare Part B covers the AWV completely, no copay, no deductible, once every 12 months. A traditional annual physical may be billed differently under Medicare.
Q5. What is a Medicare Annual Wellness Visit?
The Medicare Annual Wellness Visit (AWV) is a prevention-focused appointment covered free under Medicare Part B. It includes a Health Risk Assessment, cognitive screening, fall risk assessment, vaccine and screening review, depression screening, and a personalized prevention plan. It does not include a physical exam or automatic lab work.
Q6. Does commercial insurance cover annual physicals?
Under the Affordable Care Act, most non-grandfathered commercial plans are required to cover preventive services, including wellness visits and, in many cases, annual physicals performed as preventive visits, with no cost-sharing. Coverage details vary by plan, so it’s worth checking your specific benefits before you schedule.
Q7. Can I get blood work done at a wellness visit?
Blood work is not automatically included in a wellness visit. Your provider may order labs separately based on your health history and risk factors, and those would be billed as diagnostic services, not as part of the wellness visit itself.
Q8. What is the difference between a preventive visit and a sick visit?
A preventive visit (annual physical or wellness visit) is scheduled proactively to maintain health and catch problems early. A sick visit is scheduled in response to a specific symptom, illness, or acute concern. They are billed differently, and bringing up new symptoms at a preventive visit may trigger a separate sick-visit billing code.
About the Author
Priya Bayyapureddy
Dr. Priya Bayyapureddy, MD is a board certified Internal Medicine doctor with over 20 years of experience in primary care Internal Medicine. Dr. Bayyapureddy completed her Internal Medicine residency at Emory University School of Medicine and internship at University of Tennessee College of Medicine at Chattanooga.
