Does Medicare Require a Wellness Check Every Year?

No, Medicare does not require a wellness check every year. The Annual Wellness Visit is a voluntary preventive benefit under Medicare Part B, and about 40 percent of beneficiaries skip it in any given year.¹ Nothing happens to your coverage if you don’t schedule one. The visit costs you nothing when your provider accepts assignment, so the question most people are really asking is whether it’s worth using, not whether it’s mandatory.²

The Wellness Visit Is Not a Physical

The Annual Wellness Visit is a planning session. Your provider reviews your health history, identifies risk factors, and builds a personalized prevention plan to help you avoid disease and disability going forward. Medicare states plainly that this visit is not a physical exam.²

That matters because a traditional physical, the head-to-toe hands-on exam most people picture when they hear “checkup,” is not a covered benefit under Original Medicare. If you ask for a physical and get one, you can be billed for it. If you ask for a wellness visit, you get a conversation about prevention. Knowing the difference is the whole reason people search this question.

How Often You Can Get One

You become eligible for your first Annual Wellness Visit once you’ve been enrolled in Medicare Part B for longer than 12 months. After that, you can get one every 12 months, but you’re never obligated to.² Skipping a year doesn’t reduce your benefits or reset anything. You can pick the visit back up whenever you want, as long as at least 12 months have passed since your last one.

One boundary worth knowing: the “Welcome to Medicare” preventive visit is a separate, one-time benefit available only during your first 12 months of Part B enrollment. If you miss that window, you lose it, but you’re still eligible for the Annual Wellness Visit once the 12 months are up.³ Your first wellness visit also cannot happen within 12 months of a Welcome to Medicare visit.²

What Happens During the Visit

If you decide to use the benefit, here is what your provider covers. The core elements apply to every wellness visit, whether it’s your first or your tenth.⁴

A Health Risk Assessment questionnaire covering your health status, lifestyle, tobacco use, activity, nutrition, and alcohol use
An update to your medical and family history, including every medication and supplement you take
Routine measurements: weight, blood pressure, and body mass index
A cognitive impairment check through direct conversation
A list of your current providers and specialists
A functional ability and safety screening covering hearing, daily activities, fall risk, and home safety
A personalized prevention plan with a screening schedule tailored to your risk factors

Starting with your second visit, your provider also reviews any current opioid prescriptions and screens for potential substance use disorders.⁴

Advance Care Planning

The wellness visit is also the cheapest place to have an advance care planning conversation. This is a voluntary discussion about what kind of medical care you’d want if you couldn’t speak for yourself. When it happens as part of the wellness visit and your provider accepts assignment, you pay nothing. If the same conversation happens during a regular office visit, the Part B deductible and coinsurance apply.⁵

What It Costs and Where Bills Sneak In

The visit itself is covered at 100 percent under Part B, with no deductible and no copay, as long as your provider accepts Medicare assignment.² Assignment means the provider takes Medicare’s approved amount as full payment. Most doctors who see Medicare patients accept assignment, but confirm when you schedule.

The bills people don’t expect come from what happens around the visit. The wellness visit doesn’t include a hands-on physical exam, blood draws, lab work, or imaging. It doesn’t include diagnosing or treating a new symptom or an existing condition. If you mention a new problem and your provider evaluates it, that piece of the appointment gets billed as a standard office visit. If your provider orders lab work or imaging, those services are subject to the Part B deductible ($283 in 2026) and the usual 20 percent coinsurance.²⁶ If Medicare doesn’t cover the extra service at all, you owe the full amount.

So the wellness visit stays free, but the appointment around it may not. That’s the single most useful thing to keep in mind if you decide to schedule one.

Medicare Advantage May Cover a Real Physical

If you have a Medicare Advantage plan (Part C), the plan must cover everything Original Medicare covers, including the Annual Wellness Visit at no cost. Some Advantage plans go further and include a comprehensive annual physical as a supplemental benefit. Coverage varies plan to plan, so check your Evidence of Coverage or call the plan directly. Under Original Medicare on its own, a routine comprehensive physical is not a covered benefit, and you’d pay full cost out of pocket for one.

How to Schedule It If You Want One

Call your primary care provider and ask specifically for a “Medicare Annual Wellness Visit.” The exact phrase matters because it tells the billing staff how to code the appointment. If you ask for a “checkup” or “physical,” you may end up with a service Medicare doesn’t fully cover.

Bring these to the appointment:

A list of every medication and supplement you take, with dosages
Names and contact information for every doctor and specialist you see
Your family medical history, especially heart disease, cancer, and diabetes
Any Health Risk Assessment forms the office sent in advance

If you’ve had a Welcome to Medicare visit or a prior Annual Wellness Visit, mention the date so the office can confirm you’re past the 12-month mark. That’s the entire eligibility check. Beyond that, the visit is yours to use every year or to skip. Medicare will not ask why.

1
Centers for Medicare & Medicaid Services. 2022 Use of Preventive Care Services Among Medicare Beneficiaries
2
Medicare.gov. Yearly Wellness Visits
3
Medicare.gov. Welcome to Medicare Preventive Visit
4
eCFR. 42 CFR 410.15 – Annual Wellness Visits Providing Personalized Prevention Plan Services
5
Medicare.gov. Medicare and You 2026
6
Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles