Annual Physical vs. Medicare Wellness Visit at a Glance
| Annual Physical | Medicare Annual Wellness Visit (AWV) | |
|---|---|---|
| Main goal | Check your body for existing health problems | Create or update a personalized prevention plan |
| Format | Hands-on exam | Conversation-based visit with a questionnaire |
| Health Risk Assessment | Not standard | Yes, a required part of the visit |
| Physical exam | Yes, head to toe | No, though routine measurements like height, weight and blood pressure are taken |
| Lab tests | Often, depending on age and risk factors | Not part of the visit; ordered separately if needed |
| Medical history review | Yes | Yes, including family history and current prescriptions |
| Output | Exam findings, possible tests or referrals | Written checklist of recommended screenings and vaccines |
| Original Medicare coverage | Routine physicals are generally not covered | Covered by Part B once every 12 months |
| Cost under Original Medicare | You may owe the full cost of a routine physical | $0 if your provider accepts assignment |
What Is an Annual Physical?
An annual physical (also called a routine physical, yearly checkup or preventive exam) is a head-to-toe check-in with a doctor or other provider. It’s hands-on. The exact contents vary by age, sex, medical history and provider, but a physical often includes:
- Vital signs such as blood pressure, heart rate, temperature and weight
- Listening to your heart and lungs
- Checking your abdomen, joints, skin, eyes, ears, nose and throat as appropriate
- Reviewing your medical history, medications and lifestyle
- Ordering blood work or other tests when appropriate, such as cholesterol, blood sugar or other lab panels
- Updating vaccines and discussing age-appropriate screenings
The point of a physical is to find problems early, check on chronic conditions and give you and your provider a baseline to compare against over time. It’s also the visit many employers, schools and sports programs ask for, which is why people often search for physicals even before they’re on Medicare.
What Is the Medicare Annual Wellness Visit?
The Medicare Annual Wellness Visit (AWV) is a preventive visit designed to help you and your provider plan ahead. Medicare describes it as a conversation-based visit. It is not a routine physical exam.
During an AWV, your provider typically will:
- Ask you to complete a Health Risk Assessment, a questionnaire about your health, habits and daily life
- Take routine measurements such as height, weight and blood pressure
- Review your medical and family history
- Review your current prescriptions
- Screen for signs of cognitive impairment
- Evaluate risk factors for substance use disorder
- Offer to talk about advance directives, the documents that record your wishes about future medical care
- Give you a written checklist of the screenings, vaccines and other preventive services you should get
- Optionally review your physical activity and nutrition habits
The AWV is about the future. It asks, “What should we be doing now to keep you healthy?” It is not designed to diagnose or treat new problems.
What About the “Welcome to Medicare” Visit?
If you’re new to Medicare, you may also see the “Welcome to Medicare” preventive visit mentioned. This one-time visit is available during your first 12 months on Medicare Part B. It’s an introduction to your benefits and a review of your health history.
Your first Annual Wellness Visit can’t happen within 12 months of your Part B enrollment or your Welcome to Medicare visit. You don’t have to have had the Welcome visit before you qualify for an AWV.
Does Medicare Cover an Annual Physical?
Original Medicare (Part A and Part B) generally does not cover routine physical exams, meaning exams done without a specific symptom, complaint or diagnosis. If you get a routine physical, you may have to pay the full cost.
The Annual Wellness Visit is different. Part B covers it once every 12 months, and you pay nothing if your provider accepts assignment, meaning the provider agrees to accept Medicare’s approved amount as full payment. The Part B deductible doesn’t apply to the AWV itself.
There’s an important catch. If your provider performs additional tests or services during the same visit that Medicare doesn’t cover under the preventive benefit, you may owe coinsurance, and the Part B deductible may apply. If your provider addresses a new or existing health problem during your wellness visit, that portion can be billed separately.
Medicare Advantage (Part C) plans vary. Some cover routine physicals or extra preventive benefits beyond Original Medicare. Check your plan’s Evidence of Coverage or call the number on your member card before you book.
Which Visit Do You Need?
An Annual Wellness Visit may be the right fit if you:
- Have had Medicare Part B for more than 12 months and haven’t had an AWV in the past year
- Want a prevention plan and a personalized checklist of recommended screenings and vaccines
- Want to review medications, family history and advance directives
- Are feeling well and want a low-cost, preventive check-in
An annual physical may be the right fit if you:
- Want a hands-on exam, such as heart, lung and abdominal checks
- Want your provider to consider lab work based on your age and risk factors
- Haven’t had a full exam in a while
- Need a physical for a job, school or sports requirement (see our physical exams page)
A separate problem-focused visit may be best if you:
- Have a new symptom, an ongoing concern or a medication question. Medicare advises scheduling a separate appointment for specific health concerns so your wellness visit stays focused on prevention.
Can You Get Both on the Same Day?
Often, yes. Many providers combine them for convenience. The key is to understand what’s covered before you go:
- The Annual Wellness Visit portion is covered by Part B if you’re eligible.
- The hands-on physical portion is generally not covered by Original Medicare.
- Extra tests or problem-focused care may involve coinsurance or deductibles.
Before your appointment, ask the office: “Which parts of this visit will be billed to Medicare, and which parts might I owe for?”
How to Avoid Surprise Bills
- Say which visit you want. Ask for a “Medicare Annual Wellness Visit,” not just a “checkup.”
- Confirm your eligibility date. Your provider’s office can check when you’re next eligible.
- Ask whether the provider accepts Medicare assignment.
- Save new problems for a separate visit, or ask how they’ll be billed if discussed during your AWV.
- Check your Medicare Advantage plan if you have one. Coverage rules differ.
- Bring what the visit needs: your Medicare card, a photo ID, a list of your medications and supplements, your health history and your providers’ names, and any questions.
Annual Physicals and Wellness Visits in Las Vegas at Sahara West
Sahara West Urgent Care & Wellness offers primary care in Las Vegas that includes annual physical exams, wellness visits and preventive care. We’re a walk-in clinic that also offers same-day primary care visits when available, so you don’t have to wait weeks to get started. We welcome new patients and see people from Summerlin, Spring Valley, Enterprise, Paradise, Winchester and across the Las Vegas valley.
Here’s what sets our approach apart:
- Primary care and urgent care under one roof. If a concern comes up during your visit, you don’t need to look for a second clinic. Learn more about primary care in Las Vegas.
- On-site diagnostics. Labs, X-ray and ultrasound services are available. X-rays are offered Tuesdays and Thursdays, and ultrasounds by appointment on select Wednesdays.
- Free screening program. Ask about our free A1C diabetes and Lipoprotein(a) cardiovascular screening, subject to eligibility. See details here.
- Insurance and self-pay options. Medicare is among the plans we list. Review our accepted insurances, or ask about our membership plans if you’re uninsured or between plans.
- Evening and Saturday hours. We’re open Monday to Friday 9 am–8 pm and Saturday 9 am–3 pm at 6125 West Sahara Avenue, Las Vegas, NV 89146.
- Experienced providers. Meet our team, including our Medical Director, Dr. Mouchir Harb, MD.
Not sure which visit fits you? Call us at (702) 248-0554 and our team can help you figure out what to schedule and how coverage may apply. Or book an appointment online.
Wondering what happens at a routine appointment? Read What to Expect at a Routine Primary Care Visit.
When to Choose Urgent Care Instead
Wellness visits and physicals are for prevention. If you’re dealing with a sudden illness or minor injury, such as flu symptoms, a sprain, a cut or an infection, you don’t need to wait for a scheduled checkup. Our urgent care team treats non-life-threatening conditions on a walk-in basis. For chest pain, stroke symptoms, severe breathing trouble or other emergencies, call 911 or go to the nearest emergency room.
FAQs
Is the Medicare Annual Wellness Visit the same as an annual physical?
No. The AWV is a conversation-based prevention planning visit with a health questionnaire and routine measurements. An annual physical is a hands-on exam that may include lab tests. Medicare treats them as different services.
Does Medicare pay for an annual physical?
Original Medicare generally does not cover routine physical exams. It does cover the Annual Wellness Visit and many preventive screenings. Some Medicare Advantage plans cover more, so check with your plan.
How much does a Medicare Annual Wellness Visit cost?
Under Original Medicare, you pay nothing for the visit if your provider accepts assignment. You may owe costs if additional services are provided during the same visit that Medicare doesn’t cover as preventive.
When can I get my first Medicare Annual Wellness Visit?
After you’ve had Medicare Part B for more than 12 months. It can’t take place within 12 months of your Part B enrollment or your Welcome to Medicare visit.
How often can I get a Medicare Annual Wellness Visit?
Once every 12 months. Your provider’s office can confirm your next eligible date.
What’s the difference between the Welcome to Medicare visit and the Annual Wellness Visit?
The Welcome to Medicare visit is a one-time introductory preventive visit available in your first 12 months on Part B. The Annual Wellness Visit is a yearly prevention-planning visit that becomes available after that first year.
Can I get an annual physical and a wellness visit on the same day?
Often yes, but coverage differs. The wellness portion may be covered by Medicare, while the routine physical portion generally is not under Original Medicare. Ask the office how each part will be billed.
Does Medicare Advantage cover annual physicals?
It depends on the plan. Some Medicare Advantage plans include routine physicals or extra preventive benefits. Check your plan documents or call your insurer.
Does Sahara West accept Medicare?
Medicare is among the insurance plans listed on our insurance page. Coverage depends on your specific plan and the service, so call (702) 248-0554 and our team can help verify your benefits.
Do I need an appointment for a physical or wellness visit at Sahara West?
We’re a walk-in clinic and offer same-day primary care visits when available. For a physical or wellness visit, call or book online to confirm availability and what to bring.
Take the Next Step
Knowing which visit to book can save you time, confusion and money. If you’re ready to schedule an annual physical, ask about a wellness visit, or just want help understanding your options, we’re here.
- Call: (702) 248-0554
- Book online: Schedule your appointment
- Visit: 6125 West Sahara Avenue, Las Vegas, NV 89146 (Mon–Fri 9 am–8 pm, Sat 9 am–3 pm)
- Questions first? Contact us
This article is for general education and isn’t a substitute for professional medical advice. Medicare rules and costs can change and depend on your plan, so confirm your coverage with Medicare or your plan.
