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The Medicare Annual Wellness Visit is a free preventive visit covered by Part B with no copay or deductible -- but it is not the same as an annual physical exam.
The Medicare Annual Wellness Visit is a free preventive visit covered by Part B with no copay or deductible -- but it is not the same as an annual physical exam.
Medicare Part B covers an Annual Wellness Visit (AWV) once every 12 months. No copay, no coinsurance, no deductible. It is one of the clearest free benefits in the program.
It is also one of the most misunderstood. The Medicare Annual Wellness Visit is not a physical exam. Your doctor will not listen to your lungs, press on your abdomen, or order blood work as part of this visit. It is a structured preventive planning session -- a conversation about your health risks and a schedule for the screenings you need in the year ahead.
The number of people who walk into this appointment expecting a physical and walk out holding a bill for one is not small.
That gap between expectation and reality is worth understanding before you schedule. The visit itself costs nothing. But what happens during the appointment beyond the wellness visit can cost you plenty.
The AWV follows a structure Medicare has defined. Your provider works through several components during the appointment.
Before or at the start of your visit, you complete a health risk assessment questionnaire covering your medical history, family history, current medications and supplements, lifestyle habits (diet, exercise, smoking, alcohol use), and your ability to perform daily activities. Many practices send this form ahead of time.
Your provider reviews and updates your complete medical history -- surgeries, hospitalizations, chronic conditions, allergies. They also review family medical history to flag hereditary risk factors for conditions like heart disease, diabetes, and certain cancers.
Medicare requires a depression screening at every AWV. This is typically a short standardized questionnaire such as the PHQ-2 or PHQ-9 asking about your mood over the past two weeks. Depression is significantly underdiagnosed in older adults. This screening catches cases that would otherwise drift.
Your provider conducts a brief cognitive assessment -- not a full dementia test, but a screening to identify changes in memory, reasoning, or thinking that might warrant further evaluation. Early detection of cognitive decline matters because conditions like Alzheimer's disease respond better to intervention when caught early.
Falls are the leading cause of injury among adults over 65. During the AWV, your provider assesses fall risk by asking about recent falls, evaluating balance and gait, reviewing medications that might cause dizziness, and discussing home safety. If you are at elevated risk, they may recommend physical therapy or home modifications.
The AWV includes a conversation about advance care planning -- whether you have a living will or healthcare power of attorney in place, and if not, why documenting your wishes matters. This conversation ensures your healthcare preferences are known and recorded in your medical records.
Based on everything discussed, your provider creates or updates a personalized prevention plan: screening schedule for the coming year (mammograms, colonoscopies, bone density tests), recommended vaccinations, specialist referrals if needed, and health goals tailored to your risk factors.
Medicare offers three distinct preventive visit types. Which one applies to you depends on where you are in your enrollment.
New to Medicare Part B? You are eligible for an Initial Preventive Physical Examination (IPPE), commonly called the "Welcome to Medicare" visit, within the first 12 months of your Part B enrollment. This one-time visit is more thorough than subsequent AWVs and includes a basic physical examination, an electrocardiogram (EKG) referral, and education about available preventive services.
Important: If you miss the 12-month window for your Welcome to Medicare visit, you cannot get it later. You are still eligible for the Annual Wellness Visit after you have had Part B for at least 12 months.
After your first 12 months on Part B, you can schedule an Annual Wellness Visit once every 12 months. There is no limit on how many years you can receive this benefit.
You must wait at least 12 months after your Welcome to Medicare visit (or your last AWV) before scheduling the next one. Schedule too early and Medicare may not cover it.
This is where the billing friction lives.
| Feature | Annual Wellness Visit (AWV) | Annual Physical Exam |
|---|---|---|
| Cost to you | Free (no copay, no deductible) | Subject to copay, coinsurance, and deductible |
| Covered by Medicare Part B | Yes, as preventive benefit | Not covered by Original Medicare |
| Physical examination | Not included | Full head-to-toe exam |
| Blood work | Not included | Typically included |
| Focus | Prevention planning, risk assessment, screenings schedule | Diagnosing and evaluating current health |
| Duration | 30-60 minutes | 15-30 minutes |
| How often | Once every 12 months | As needed (you pay out of pocket) |
| Stethoscope, blood pressure, weight | Basic measurements only | Full vitals and examination |
The AWV is about planning and prevention. The annual physical is about examining and diagnosing. Medicare covers the first but not the second.
Some Medicare Advantage plans do cover an annual physical exam as an extra benefit. Check your specific plan documents.
The following services are not part of the free Annual Wellness Visit:
Here is the tradeoff you need to understand: if your provider performs any of these services during the same appointment, those services get billed separately under different billing codes. You owe your normal Part B cost-sharing -- typically 20% coinsurance after the deductible -- on every additional service.
This is the single most common source of surprise bills tied to the AWV. Your visit was free. The exam your doctor added was not. For more on understanding your medical bills, see our guide on accessing your billing records.
The system probably should not work this way -- a free preventive visit that can silently convert into a billable encounter mid-appointment puts the burden of vigilance on the patient -- but it does, and knowing that going in is the only real protection.
Preparation makes the difference between a useful visit and a wasted one.
Bring these items:
Before the visit:
That second bullet matters more than it looks. Asking upfront about additional charges is the most reliable way to avoid a surprise bill.
Most primary care providers who accept Medicare can perform the Annual Wellness Visit.
When scheduling, specifically request an "Annual Wellness Visit" -- not an "annual physical" or "annual checkup." The terminology determines how the visit gets coded and whether Medicare covers it.
Tip: Providers who accept Medicare assignment agree to charge no more than the Medicare-approved amount. You can verify assignment status through Medicare's online directory.
The AWV is not dramatic. Nobody has ever described it as a life-changing medical event. Its value is structural -- it keeps prevention on schedule and catches things that build slowly.
Your Annual Wellness Visit generates documentation -- health risk assessment, prevention plan, screening recommendations. Request a copy of your prevention plan and keep it with your personal health records. Complete records make every future healthcare interaction more effective.
For guidance on obtaining and organizing your medical records, see our complete guide to accessing your records or learn how to request medical records from any provider.
No. The Annual Wellness Visit must be performed by a primary care provider -- a family physician, internist, geriatrician, physician assistant, or nurse practitioner.
If your provider identifies a health concern during the AWV and decides to address it during the same visit, the treatment portion will be billed separately. You will owe your normal cost-sharing for that additional service.
No. The Welcome to Medicare visit (IPPE) is a one-time visit available only during your first 12 months on Part B. The AWV is the annual preventive visit available every 12 months thereafter.
Yes. You can schedule your first AWV after you have been enrolled in Part B for at least 12 months, regardless of whether you had a Welcome to Medicare visit.
Yes. All Medicare Advantage plans must cover the same preventive benefits as Original Medicare, including the Annual Wellness Visit at no cost to you. Many MA plans offer additional preventive benefits beyond what Original Medicare covers.
This information is educational and does not replace professional medical or legal advice.
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