- February 18, 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.
The Medicare Annual Wellness exam is a preventive visit designed to help adults stay ahead of serious health conditions. Unlike a traditional annual physical exam, this Medicare-covered visit focuses on preventive healthcare, chronic disease risk assessment, and long-term wellness strategies.
Covered under Medicare Part B, the Annual Wellness Visit (AWV) includes a comprehensive health risk assessment, review of medical history, cognitive screening, and the development of a customized prevention plan.
Understanding what the Medicare Annual Wellness Exam includes, how it differs from a routine physical, can help you maximize your Medicare benefits while prioritizing early disease detection and preventive care.
Understanding Medicare Preventive Care
- Part A covers hospital care
- Part B covers outpatient and preventive services
- Part C (Medicare Advantage) is offered through private insurers as an alternative
- Part D covers prescription drugs
Medicare's Approach to Preventive Care
Medicare structures preventive care differently from most commercial insurance plans. Instead of a traditional comprehensive physical examination, Medicare offers two distinct types of preventive visits: the Welcome to Medicare Visit and the Annual Wellness Visit.
Initial Preventive Physical Examination (Welcome to Medicare Visit)
- Comprehensive health history review, including risk factors
- Review of current medical conditions and medications
- Physical measurements (height, weight, blood pressure, body mass index)
- Vision screening using basic equipment
- Assessment of cognitive function
- Review of your potential need for preventive screenings
- End-of-life planning discussion if you choose
- Referrals for other covered preventive services
- Written plan outlining recommended screenings and services
Annual Wellness Visit
- Health Risk Assessment questionnaire that you complete
- Update of your medical and family history
- Creation or update of your personalized prevention plan
- Measurement of height, weight, blood pressure, and body mass index
- Detection of cognitive impairment
- Depression screening
- Review of your current medications and supplements
- Discussion of falls risk
- Recommendations for appropriate preventive services
What Medicare's Wellness Visits Don't Include
- Comprehensive physical examination of body systems
- EKG for cardiac examination
- Abdominal palpation
- Musculoskeletal assessment
- Neurological examination beyond cognitive screening
- Breast examination
- Pelvic examination
- Prostate examination
- Detailed evaluation of specific symptoms or concerns
Routine Screening Tests: What's Covered and How Often?
Medicare covers numerous preventive screening tests beyond the wellness visit itself. Understanding coverage rules helps you schedule appropriate tests without unexpected charges.
Cardiovascular Screening
Covered services:
- Cardiovascular disease screening (cholesterol, lipid panel, triglycerides): Once every five years
- Blood pressure measurement during each wellness visit
- One-time abdominal aortic aneurysm ultrasound screening for men ages 65-75 who have ever smoked
Cancer Screening
Breast cancer:
- Mammogram screening: Once every 12 months for women 40 and older
- No age limit for Medicare coverage
Cervical and vaginal cancer:
- Pap smear: Once every 24 months
- Once every 12 months for women at high risk
- Pelvic examination: Once every 24 months
Colorectal cancer:
- Colonoscopy: Once every 10 years (every 2 years if high risk)
- Flexible sigmoidoscopy: Once every 4 years
- Fecal occult blood test: Once every 12 months
- Multi-target stool DNA test: Once every 3 years
Prostate cancer:
- PSA test: Once every 12 months for men 50 and older
- Digital rectal examination: Once every 12 months
Lung cancer:
- Low-dose CT scan: Once every 12 months
Diabetes Screening
Medicare covers diabetes screening tests (fasting glucose or hemoglobin A1C) up to twice per year if you have certain risk factors, including high blood pressure, cholesterol problems, obesity, or a history of high blood sugar.
Bone Density Testing
Medicare covers bone mass measurements once every 24 months (more frequently if medically necessary) for:
- Women 65 and older
- Men at risk for osteoporosis
- People with certain medical conditions or taking medications that affect bone mass
Depression and Mental Health Screening
Medicare covers annual depression screening and face-to-face behavioral therapy for beneficiaries diagnosed with depression.
Hepatitis C Screening
One-time screening for adults born between 1945 and 1965, and annually for beneficiaries at high risk.
Immunizations Covered by Medicare
Vaccine coverage is split between Medicare Part B and Part D, which confuses many beneficiaries.
Part B Covers (no cost-sharing):
- Flu shots (once per flu season)
- Pneumococcal shots (Pneumovax, Prevnar)
- Hepatitis B vaccine
- COVID-19 vaccines
Part D Covers (may have cost-sharing):
- Shingles vaccine (Shingrix)
- Tdap (tetanus, diphtheria, pertussis)
- Other vaccines not covered by Part B
Medicare Advantage and Wellness Visits
If you have Medicare Advantage (Part C), your coverage may differ. Many Medicare Advantage plans offer enhanced benefits beyond Medicare, including annual physical examinations at no cost.
Check your Medicare Advantage plan for:
- Whether they cover a traditional physical exam beyond the wellness visit
- Which providers are in-network for preventive services
- Whether you need referrals
- Plan-specific cost-sharing requirements
Maximizing Your Medicare Preventive Benefits
Strategic planning helps you get the most value from your Medicare preventive coverage.
Schedule Your Wellness Visit Strategically
- Don’t wait until you’re sick to schedule your wellness visit
- Plan it during a time when you’re feeling well and can focus on prevention
- Bring a list of all current medications and supplements
- Complete any required health risk assessment forms beforehand
- Write down questions about preventive screenings or health concerns
Track Your Screening Schedule
Keep a personal health calendar noting when you’re due for:
- Mammograms
- Colonoscopy
- Bone density testing
- Cardiovascular screening
- Other age-appropriate tests
Common Mistakes Medicare Beneficiaries Should Avoid
Trusted Medicare Wellness Visits Near You in Alpharetta and Lawrenceville, GA
- Complete health risk assessment
- Personalized prevention plan
- Cognitive impairment screening
- Review of current medications
- Depression screening
- Advance care planning discussion
Conclusion
Understanding Medicare’s preventive care structure helps you make informed decisions about your healthcare. The Annual Wellness Visit provides valuable preventive services focused on early detection and disease prevention, even if it doesn’t match your expectations of a traditional physical examination.
The key is using all of Medicare’s preventive benefits strategically:
- Take advantage of your one-time Welcome to Medicare visit
- Schedule your Annual Wellness Visit every year
- Get age-appropriate screening tests at recommended intervals
- Separate preventive care from diagnostic evaluation when possible
- Understand what you’ll pay before services are performed
The goal is to stay healthy and catch problems early. When you find a healthcare provider that helps you make the most of your preventive benefits, you’ve found a valuable partner in maintaining your health throughout your retirement years.
FAQs:
1. Is a Medicare Annual Wellness Visit the same as a physical exam?
No. It focuses solely on prevention and screening. A full physical exam requires a separate, cost-sharing appointment.
2. How often can I get a Medicare Annual Wellness Visit?
Once every 12 months after your first year on Medicare Part B.
3. What do I need to bring to my Medicare wellness visit?
A full medication list, your health history, family medical history, and any questions about recommended screenings.
4. Can I use telehealth for my Medicare Annual Wellness Visit?
In some cases, yes. Medicare covers telehealth wellness visits for eligible beneficiaries. Confirm with your provider beforehand.
5. Can annual blood work detect serious health problems?
Yes, it can identify early signs of diabetes, anemia, thyroid disorders, liver disease, and heart disease.
6. When should men start prostate cancer screening?
To avoid average to higher risk, men should generally start at age 50 for prostate cancer screening.
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.
