Does Medicare Cover Physicals?
Medicare does not cover routine physical examinations, but it does cover an Annual Wellness visit and a "Welcome to Medicare" visit.
If your doctor orders further tests or health care services during your visit, you may face certain Medicare costs such as coinsurance, deductibles and copays.
A Medicare Supplement (Medigap) plan can help pay for your out-of-pocket Medicare costs for outpatient care ordered by your doctor or health care professional during a physical.
Medicare Covers Your "Welcome to Medicare" Visit
Your Welcome to Medicare Visit is available for the first 12 months that you have Medicare Part B (medical insurance).
During your Welcome to Medicare visit, you speak with your health care provider about your medical and social history.
You may also receive exams of certain aspects of your physical and mental health, such as:
Counseling about certain screenings or shots you may require
Height, weight, blood pressure, and body mass index measurements
A basic vision test
A review of your risk for depression
A written plan detailing what steps for preventive care you should take
What Is Your Annual Wellness Visit?
After your one-time welcome visit, you're entitled to one annual wellness visit each year.
Your Annual Wellness Visit is a yearly check-in with your doctor where you can review or update your medical history and learn about the preventive services that could be beneficial to you.
Your Annual Wellness Visit is covered by Medicare Part B.
At your Annual Wellness Visit, you’ll meet with your doctor to develop (or update) a personalized prevention plan. This plan can help you to stay healthy, and includes:
A review of your medical history
A review of your prescription medications and providers
Height, weight, and other routine physical examinations and measurements
A screening schedule for preventive services you should undergo
And other personalized health advice
Although your Welcome to Medicare visit and your annual wellness visit are not technically physical exams, in many ways they accomplish similar things.
Do Medicare Supplement Plans Cover Annual Physicals?
Though these two types of Medicare visits are completely covered if you see a provider who accepts Medicare assignment, there are numerous out-of-pocket costs that you'll likely face for other medical services.
Some of the out-of-pocket costs you should be prepared to pay include:
Medicare Part B deductible
In 2024, the standard Medicare Part B deductible is $240 per year. Your Medicare Part B deductible must be paid before Medicare will begin paying its share of Medicare-approved services.
Medicare Part B coinsurance
Once your Part B deductible is met, Medicare pays 20 percent of the Medicare-approved amount for a service.
These out-of-pocket costs are in addition to your monthly Medicare Part B premium. In 2024, the standard Part B premium is $174.70 per month.
Medicare Supplement Insurance (Medigap) helps cover some of Medicare's out-of-pocket costs. Medigap Plan G in particular covers annual physicals and other comprehensive needs.
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient treatments as a result of a physical exam.
Learn more about common procedures that Medicare covers.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.