Quick Answer
Medicare Part B covers the Annual Wellness Visit (AWV) at 100% - no copay or deductible - once every 12 months. It is not a physical exam but a personalized prevention plan visit that reviews your health history, updates your risk assessments, and helps you and your doctor create a health roadmap for the year ahead.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Part A (Hospital) | Not Covered | Part A covers inpatient hospital services, not outpatient wellness visits. |
| Part B (Medical) | Fully Covered | $0 cost to you - no copay, no deductible - once every 12 months. |
| Medicare Advantage (Part C) | Covered | All Medicare Advantage plans must cover the AWV at no cost. Many also offer additional wellness benefits. |
| Medigap | Not Applicable | Medigap supplements Original Medicare cost-sharing. Since the AWV has no cost-sharing, Medigap is not involved. |
Understanding Your Coverage Options
Medicare Part B
Medicare Part B covers the Annual Wellness Visit as a preventive service at 100% - meaning you pay nothing as long as the visit is billed correctly as a wellness visit. There is no copay and the Part B deductible does not apply.
You are eligible for your first AWV after you have been enrolled in Part B for more than 12 months. After that, you can schedule one every 12 months. The visit must be with a physician, physician assistant, nurse practitioner, clinical nurse specialist, or a health professional working under direct supervision of a physician.
What It Covers
- Review of your medical and family history
- Updating your list of current providers and medications
- Blood pressure, height, weight, and BMI measurements
- Cognitive impairment assessment (e.g., memory and thinking)
- Screening for depression and functional ability
- Personalized health advice and referrals as needed
- Creation or update of a 5-to-10 year prevention plan
- Review of your advance care planning (living will, healthcare proxy)
What It Doesn't Cover
- Physical examination or hands-on medical evaluation
- Diagnosis or treatment of existing conditions
- Lab work or blood tests (billed separately if ordered)
- Vaccinations (billed separately under Part B or Part D)
$ Cost: $0 for the Annual Wellness Visit itself. Additional services performed at the same appointment may be billed separately.
Watch for Extra Charges
If your doctor addresses a new or existing medical problem during your AWV, that portion of the visit may be billed as a separate office visit - and cost-sharing may apply. Ask your doctor to keep the AWV focused on prevention to avoid unexpected charges.
Medicare Advantage (Part C)
All Medicare Advantage Plans are required to cover the Annual Wellness Visit with no cost-sharing, matching Original Medicare's benefit. Many plans go further by offering additional wellness programs, health coaching, or care coordination services tied to the AWV.
Some Medicare Advantage Plans also include a more comprehensive annual physical exam as an added benefit beyond what Original Medicare provides. Check your plan's Evidence of Coverage (EOC) document to understand what's included.
What It Covers
- All AWV services covered under Original Medicare Part B
- Many plans add care coordination follow-up after the visit
- Some plans include a comprehensive physical exam as an extra benefit
What It Doesn't Cover
- Services not covered by Original Medicare or your specific plan
- Out-of-network providers (for HMO plans)
Annual Wellness Visit Cost Summary (2026)
| Service | Your Cost | Notes |
|---|---|---|
| Annual Wellness Visit (AWV) | $0 | Covered 100% by Part B; no deductible applies |
| Lab work ordered at AWV | Varies | Billed separately; Part B deductible and 20% coinsurance may apply |
| Vaccines given at AWV | $0 (most) | Most preventive vaccines covered at 100% under Part B or Part D |
| Treatment for a medical problem at same visit | Varies | Billed as a separate office visit; cost-sharing applies |
| Welcome to Medicare Visit (one-time) | $0 | Separate one-time visit in your first 12 months of Part B |
✦ AWV vs. Welcome to Medicare Visit vs. Physical Exam
Welcome to Medicare Preventive Visit
This is a separate one-time visit available within the first 12 months of your Part B enrollment. It includes a review of your health history, preventive screenings, and referrals. You must have this visit before you are eligible for your first Annual Wellness Visit.
One-time only - available in your first 12 months of Part B
Annual Wellness Visit (AWV)
Available once every 12 months after your first 12 months of Part B enrollment. Focuses on prevention planning, health risk assessments, and updating your health records. Does not include a physical exam.
Once per year - no physical exam included
Physical Exam (Annual Physical)
Original Medicare does not cover a routine annual physical exam. If your doctor performs a hands-on physical examination, that service is typically billed as an office visit and cost-sharing applies. Some Medicare Advantage Plans include a physical exam as an added benefit.
NOT covered by Original Medicare - may be included in some MA plans
How to Prepare for Your Annual Wellness Visit
Getting the most from your AWV starts before you walk in the door. Bringing the right information and asking the right questions can turn a routine appointment into a genuinely useful health planning session.
Before your visit, gather a complete list of all prescription medications, over-the-counter drugs, vitamins, and supplements you take - including dosages. Write down any health concerns, symptoms, or questions you want to discuss. Review your family health history for any updates. Bring your Medicare card and any supplemental insurance cards.
During the visit, be honest about lifestyle factors like diet, exercise, alcohol use, and sleep. Ask your doctor to explain your personalized prevention plan and what screenings are recommended for your age and risk factors. Discuss advance care planning if you haven't already - this is the right time to review or create a living will or healthcare proxy.
AWV Preparation Checklist
- Complete medication list (prescriptions, OTC, vitamins, supplements)
- List of current doctors and specialists
- Any recent lab results or test reports
- Written list of health questions or concerns
- Family health history updates
- Medicare card and supplemental insurance cards
- Advance directive or healthcare proxy documents (if you have them)
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a Medicare content writer at MedicareFAQ with extensive experience explaining Medicare benefits, enrollment, and coverage options to beneficiaries.
Ashlee Zareczny
ReviewerAshlee Zareczny is the Compliance and Editorial Manager at MedicareFAQ, ensuring all Medicare content is accurate, up-to-date, and compliant with CMS guidelines.