Medicare Preventive Services: Annual Wellness Visit 2026

Medicare does not cover a routine annual physical. But it does cover something different - and in many ways more useful: a free Annual Wellness Visit every year plus more than 20 preventive screenings, vaccinations, and counseling services at $0 cost to you. Millions of Medicare beneficiaries skip these benefits because they assume Medicare only covers care when you are sick. That is a costly mistake. Understanding what Medicare’s preventive benefits include - and how to access them without triggering unexpected bills - is one of the most valuable things any Medicare beneficiary can learn.

This guide explains the Annual Wellness Visit, the Welcome to Medicare Visit, and the full list of preventive services Medicare covers in 2026 under Medicare Part B.

Annual Physical vs. Annual Wellness Visit: The Key Distinction

This is the most important thing to understand about Medicare’s preventive benefits:

Medicare does not cover a “routine annual physical.” A traditional head-to-toe physical examination of a healthy person with no specific complaints is not a covered Medicare benefit. If you ask your doctor for an annual physical the way you might have gotten one through employer insurance, Medicare will bill you for it as a regular office visit. You will owe the Part B deductible ($257 in 2026) plus 20% coinsurance.

Medicare does cover an Annual Wellness Visit (AWV). The AWV is a structured assessment of your health risks, medications, and prevention plan. It looks forward - what health risks do you face, and what screening and prevention steps do you need? - rather than performing a physical examination of your body. You pay $0 for the AWV itself.

The confusion is understandable because both involve a visit to your doctor. The billing code is different, and the scope of the visit is different. When scheduling, tell your doctor’s office: “I want to schedule my Medicare Annual Wellness Visit.” Those exact words matter for how the visit is coded.

Welcome to Medicare Visit

New to Medicare? Your first preventive benefit is the Welcome to Medicare Visit, officially called the Initial Preventive Physical Examination (IPPE). This is a one-time visit available during your first 12 months of Medicare Part B coverage.

What it includes:

  • Review of your medical and social history, including risk factors for depression and functional limitations
  • Measurement of height, weight, blood pressure, and body mass index (BMI)
  • Vision test
  • Review of current medications and supplements
  • Brief written prevention plan listing which screenings and vaccinations you need based on your age, health history, and risk factors
  • Assessment of functional ability and safety - fall risk, ability to perform daily activities, and home safety
  • Electrocardiogram (EKG) if your risk profile warrants it
  • Referrals to any screenings or specialists needed based on the review

Cost: $0. The Welcome to Medicare Visit is fully covered under Part B with no deductible or coinsurance.

Timing: Schedule this visit within your first year of Medicare. If you miss the 12-month window, you cannot go back and use it. But the Annual Wellness Visit becomes available starting one year after your Medicare Part B start date, so you will still have access to a free preventive visit.

Annual Wellness Visit

Starting 12 months after your Welcome to Medicare Visit - or 12 months after your Part B start date if you did not have the Welcome to Medicare Visit - you can schedule an Annual Wellness Visit once every 12 months.

What it includes:

  • Personalized prevention plan based on your current health status and risk factors
  • Update to your medical history and list of current providers and medications
  • Measurement of height, weight, blood pressure, and BMI
  • Cognitive impairment detection - your doctor will assess memory, attention, and reasoning through brief questions or a standardized tool such as the Mini-Cog or Montreal Cognitive Assessment. This is one of the most important parts of the AWV for older adults and is often overlooked in regular office visits.
  • Fall risk assessment - review of balance, gait, and medications that increase fall risk
  • Review of functional ability (how well you manage daily tasks like driving, cooking, or managing finances)
  • Depression screening using a validated questionnaire
  • Schedule of which preventive screenings and vaccinations are due based on your age, sex, and health history
  • Advance care planning discussion - optional but encouraged, and separately billable if done in depth

What it does not include: A physical examination of your body systems. The AWV does not include the doctor listening to your heart and lungs, examining your abdomen, or checking reflexes - that is the physical exam portion that requires a regular office visit with cost-sharing. If you have a specific health concern, mention it as a separate issue. The doctor will address it, but that part of the visit may be billed as a regular evaluation and management service, not a covered AWV service.

Cost: $0 - fully covered under Medicare Part B with no deductible or coinsurance, once per 12-month period.

The Diagnostic Conversion Trap

The most important billing pitfall with the AWV is what happens when the doctor finds something during the visit and investigates it further.

Example: You schedule an AWV. Your doctor measures your blood pressure and finds it elevated, then decides to spend additional time evaluating the cause and adjusting your medications. The visit has shifted from preventive to diagnostic for that portion. Medicare may bill the diagnostic portion as a separate evaluation and management visit - and you could owe the Part B deductible and 20% coinsurance on that component.

This does not mean you should hide symptoms from your doctor. It means you should understand that a “free” wellness visit can include a cost-bearing component if the doctor addresses a specific medical problem during the same appointment.

How to handle it: If you have specific health concerns beyond the wellness assessment, consider scheduling a separate regular office visit for those issues. Or ask your provider upfront how the visit will be coded if they find something that needs follow-up. Many primary care offices will combine the AWV and a problem-focused visit in a single appointment, which is allowed - just be prepared for a possible charge for the problem-focused portion.

Preventive Screenings Covered by Medicare Part B

Medicare Part B covers the following preventive screenings at $0 cost when performed by a participating provider and coded correctly as preventive services:

Cancer Screenings

Mammogram (breast cancer): Annual screening mammogram for women 40 and older. A one-time baseline mammogram is covered between ages 35 and 39. $0 with no deductible.

Pap test and pelvic exam (cervical and vaginal cancer): Covered once every 24 months for most women. Covered once every 12 months for women at high risk for cervical cancer or for women of childbearing age who had an abnormal Pap test in the past 3 years. $0 for the Pap test; the pelvic exam cost-sharing depends on the circumstances.

Colorectal cancer screening: Multiple test options are covered. A fecal occult blood test (FOBT or FIT) is covered annually. Flexible sigmoidoscopy is covered every 48 months. A standard colonoscopy is covered every 10 years for average-risk beneficiaries and every 2 years for high-risk individuals. Cologuard (stool DNA test) is covered every 3 years for average-risk patients ages 45-85. See Medicare colonoscopy and colorectal screening coverage for the full breakdown.

Lung cancer screening: Annual low-dose CT scan for Medicare beneficiaries ages 50 to 77 who have smoked at least 20 pack-years (a pack-year = one pack per day for one year) and who currently smoke or quit within the past 15 years. Requires a written order. $0 cost.

Prostate cancer screening: Annual PSA blood test covered for men 40 and older. Annual digital rectal exam (DRE) also covered. $0 for both tests.

Cardiovascular Screenings

Cholesterol and lipid panel: A fasting lipid panel is covered once every 5 years for all Medicare beneficiaries. Blood pressure measurement is included at every AWV, Welcome to Medicare Visit, and most Medicare-covered office visits. $0.

Cardiovascular disease behavioral counseling: Intensive behavioral therapy for cardiovascular disease prevention - face-to-face counseling sessions in a primary care setting - is covered for eligible beneficiaries. $0.

Diabetes Services

Diabetes screening: Up to two fasting blood glucose tests per year for beneficiaries at risk for diabetes (overweight, high blood pressure, abnormal cholesterol, history of gestational diabetes, or family history of diabetes). $0.

Diabetes self-management training (DSMT): Up to 10 hours of initial training plus 2 hours per year of ongoing training for beneficiaries with a diabetes diagnosis, when referred by a physician. A valuable benefit that many people with Medicare and diabetes never use because their doctor doesn’t mention it. $0 for the training itself.

Medical Nutrition Therapy (MNT): Up to 3 hours of individualized nutritional counseling with a registered dietitian in the first year, with unlimited follow-up sessions in subsequent years, for beneficiaries with diabetes or chronic kidney disease. Requires a physician referral. $0.

Diabetes Prevention Program (DPP): Medicare covers the CDC-recognized Diabetes Prevention Program - a structured lifestyle change program - for beneficiaries who are overweight, do not yet have diabetes, and have a blood test showing prediabetes. Up to 2 years of group sessions available. $0.

Bone Health

Bone density test (DEXA scan): Covered once every 24 months - or more often if medically necessary - for beneficiaries at risk for osteoporosis: women who have been told by their doctor they are at risk, individuals on long-term corticosteroid therapy, individuals with a history of osteoporotic fracture, and those with certain other conditions. $0.

Mental and Behavioral Health Screenings

Depression screening: Annual screening using a validated questionnaire, covered in a primary care setting. If depression is identified and the doctor addresses it during the same visit, that portion may generate a charge. $0 for the screening itself.

Alcohol misuse screening and counseling: Annual brief screening plus up to four brief counseling sessions per year for beneficiaries who screen positive. $0. See Medicare mental health coverage for more on behavioral health benefits.

Tobacco cessation counseling: Up to 8 sessions per year (two 90-day cessation attempts, four sessions each) for any Medicare beneficiary who uses tobacco. $0.

Other Preventive Screenings

Abdominal aortic aneurysm (AAA) screening: One-time abdominal ultrasound to screen for aortic aneurysm, covered for men who have smoked at least 100 cigarettes in their lifetime. Available during the first year of Medicare as part of the Welcome to Medicare Visit referral. $0.

Glaucoma screening: Annual dilated eye exam to screen for glaucoma, covered for high-risk patients: those with diabetes, a family history of glaucoma, African Americans age 50 or older, and Hispanic Americans age 65 or older. See Medicare eye disease and glaucoma coverage for details. $0.

Hepatitis C screening: One-time screening for all adults born between 1945 and 1965 (the baby boomer cohort), plus annual screenings for those at ongoing high risk. $0.

Hepatitis B screening: Covered for high-risk patients. $0. (Hepatitis B vaccination is also covered under Part B for medium- and high-risk beneficiaries.)

HIV screening: One-time screening for all Medicare beneficiaries ages 15 to 65, and once per year for those at increased risk. $0.

STI counseling and screening: Annual high-intensity counseling for sexually active adults at increased risk, plus screenings for gonorrhea, chlamydia, and syphilis. $0.

Obesity behavioral counseling: Up to 22 face-to-face counseling sessions in the first year for beneficiaries with a BMI of 30 or higher. Must be conducted in a primary care setting. $0.

Vaccinations Covered by Medicare

Vaccines are one of Medicare’s strongest preventive benefits:

Under Part B (no cost-sharing):

  • Influenza vaccine: One shot per flu season. The high-dose or adjuvanted formulation is recommended for adults 65+ and is fully covered.
  • Pneumococcal vaccines: The CDC recommends two pneumococcal vaccines for adults 65+ - either PCV20 alone, or PCV15 followed by PPSV23. Both are covered at $0 under Part B.
  • COVID-19 vaccines and boosters: Covered at $0 under Part B.
  • Hepatitis B vaccine: Covered at $0 for medium- and high-risk beneficiaries.

Under Part D (no cost-sharing as of 2023): The Inflation Reduction Act eliminated cost-sharing for all ACIP-recommended vaccines under Part D. This includes:

  • Shingrix (shingles): Two-dose series, recommended for adults 50+. $0 through your Part D plan in-network.
  • Tdap (tetanus, diphtheria, pertussis): $0 through Part D.
  • All other ACIP-recommended vaccines not covered under Part B.

If you have a Medicare Advantage plan, vaccines are covered the same way - Part B vaccines at $0, and Part D vaccines at $0 in-network under ACIP recommendations.

Medicare Advantage and Preventive Services

Medicare Advantage plans must cover all Original Medicare preventive services at $0 cost-sharing when you use in-network providers. Many Advantage plans offer additional benefits Original Medicare does not cover:

  • Routine vision exams and eyewear allowances
  • Routine hearing exams and hearing aid allowances
  • Routine dental cleanings and preventive dental care
  • Fitness memberships (Silver Sneakers or similar programs)
  • Over-the-counter preventive product allowances (vitamins, sunscreen, first-aid supplies)
  • Transportation to medical appointments

The tradeoff is that Advantage plans have provider networks - preventive services from out-of-network providers may cost more or not be covered. Original Medicare lets you see any participating provider nationwide with no network restrictions.

How to Get the Most from Medicare’s Preventive Benefits

Use the right language when scheduling. Call your doctor’s office and ask specifically for your “Medicare Annual Wellness Visit.” If the scheduler just books a regular “physical” or “annual exam,” the visit may be billed as a regular office visit with cost-sharing.

Come prepared. Bring a written list of all prescription medications, over-the-counter drugs, vitamins, and supplements - with doses. This is the single most useful thing you can do. The medication review is one of the highest-value parts of the AWV for identifying dangerous interactions or duplications.

Ask for your prevention plan in writing. At the end of the AWV, your provider should give you a personalized prevention plan listing which screenings are due and on what schedule. Keep this document and use it to track what you need each year.

Don’t skip the cognitive assessment. The AWV includes a required cognitive screening. If you or a family member has any memory concerns, the AWV is the right time to raise them. Ask for a more complete evaluation if a brief screening tool feels insufficient.

Use preventive benefits proactively. Medicare covers screenings to detect problems early - when treatment is most effective and least costly. A colonoscopy that finds and removes a precancerous polyp costs Medicare far less than treating colorectal cancer. A depression screening that catches and treats early depression avoids hospitalizations. These benefits exist precisely because prevention is cheaper than treatment.

Know the “in-network” rule for Advantage plans. If you are on a Medicare Advantage plan, verify that your primary care doctor is in-network before scheduling your AWV. Out-of-network primary care on most HMO plans is not covered at all.

Coordinate with your Medicare Part D plan on vaccines. Ask your pharmacist which vaccines are due and whether they can administer them at the pharmacy - Part D vaccines (Shingrix, Tdap) are often easiest to get at a pharmacy, which is an in-network Part D provider for most plans.

What Medicare Does NOT Cover

Even with Medicare’s extensive preventive benefits, some common health maintenance services are not covered:

  • Routine annual physical examinations - the traditional head-to-toe exam in the absence of a medical complaint
  • Routine dental care - cleanings, fillings, extractions (see Medicare dental, vision, and hearing coverage for exceptions and alternatives)
  • Routine vision exams for glasses or contacts - Medicare covers eye exams for glaucoma and diabetic retinopathy, but not routine refraction
  • Routine hearing exams and hearing aids - Original Medicare does not cover them; many Advantage plans do
  • Acupuncture - covered only for chronic low back pain under Medicare
  • Gym memberships - covered only through select Medicare Advantage plans

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