“A yearly checkup” can mean different things. Under Original Medicare, a preventive welcome visit, a yearly wellness visit and a routine physical have different rules. The appointment name alone does not tell you what you will owe.
Updated October 21, 2026
This guide explains national Original Medicare Part B rules checked October 21, 2026. If you have Medicare Advantage, ask your exact plan about its network, coverage and billing rules. Helen has not checked your enrollment, visit history, provider or personal eligibility.
Medicare covers one “Welcome to Medicare” preventive visit during your first 12 months with Part B. It reviews your health history and preventive care needs. It is not a full routine physical. Ask the office to confirm that this is the visit you are booking and that you are still within the covered time period.
This visit helps create or update a prevention plan and includes a health risk assessment. It is not a routine physical. Medicare covers it once every 12 months for eligible people. Your first wellness visit cannot be within 12 months of starting Part B or having a Welcome visit. A prior wellness visit also affects when the next one is covered. You do not need to have had a Welcome visit to qualify. Ask the office to check your next eligible date; a new calendar year alone does not confirm it.
For a covered Welcome or yearly wellness visit, you pay nothing when the provider accepts Medicare assignment. The Part B deductible does not apply to that covered preventive visit. This does not make every service at the appointment free. Separate illness care, tests or other added services may have a deductible or coinsurance. Uncovered services may be fully your responsibility. Ask what will be billed separately before the visit.
Original Medicare does not cover a routine physical exam done without a link to diagnosing or treating a particular illness, symptom, complaint or injury. You may owe its full cost. That rule does not mean every exam, screening or test is excluded: covered preventive benefits and care for a health problem have their own rules. Ask which service the office intends to provide.
Bring your health and vaccine records, family health history, medication and supplement list, and the names of your care providers. Tell the office about concerns you want to discuss, and ask whether they need a separate appointment or charge. Do not assume a discussion of a health problem is included in the preventive visit at no cost.
Ask the billing office to identify the preventive visit and any separate services. Compare the bill with your Medicare Summary Notice, which is not a bill. Ask about a possible claim error and the reason for any denial. For coverage questions, call Medicare at 1-800-633-4227 (TTY: 1-877-486-2048), or use its official contact page to find free SHIP counseling.
Name the appointment
“Am I booking a Welcome to Medicare visit, a yearly wellness visit, a routine physical or a visit for a health problem? Please check my Part B start date and prior preventive visits to confirm when this is covered.”
Check assignment and added charges
“Do you accept Medicare assignment for this visit? Will anything be billed separately, such as tests or care for a health problem? What might I owe for those services?”
Ask how to prepare
“Which records should I bring? If I also want to discuss a health concern, should I book a separate visit? Please explain any extra charge before we proceed.”
The benefit has a 12-month timing rule, and Part B enrollment and prior Welcome or wellness visits matter. Ask the office or Medicare to check your next eligible date.
No. A Welcome visit is not required first. You still need to meet the yearly wellness visit’s enrollment and timing rules.
See what’s on your card.
Take a photo. Get every number and term explained in plain English — free, for everyone.
Scan my insurance card →