Does job-based or Marketplace insurance cover annual physical?

Yes, an annual preventive visit is usually covered at $0 in network. ACA-compliant plans cover preventive visits and recommended screenings without cost sharing. If you discuss a new problem or manage a chronic condition in the same visit, part of it can be billed as a regular office visit. Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.

Does Original Medicare cover annual physical?

Medicare covers a yearly wellness visit at $0, but not a traditional head-to-toe physical. Part B covers a one-time “Welcome to Medicare” visit and a yearly wellness visit to update your prevention plan. A routine comprehensive physical exam is not covered, and extra tests or problem-focused care can cost you. Cost: Wellness visit is $0 with an assigning provider; added diagnostic services generally cost 20% after the deductible.

Does Medicare Advantage cover annual physical?

Usually yes: Medicare Advantage covers the wellness visit and many plans add a routine physical. Plans must cover Medicare’s yearly wellness visit and often add an annual routine physical as an extra benefit. Use an in-network primary care provider.

Does Medicaid cover annual physical?

Yes, Medicaid covers preventive checkups. State Medicaid programs cover preventive visits. Children and teens get full well-child checkups under a federal rule called EPSDT.

Is annual physical covered by insurance?

A yearly preventive checkup with your primary care clinician. Here’s how each kind of plan usually handles it.

Ask a specific question Plan a visit: cost and doctors Check it against my plan

Employer or MarketplaceUsually covered
Yes, an annual preventive visit is usually covered at $0 in network.
More details
ACA-compliant plans cover preventive visits and recommended screenings without cost sharing. If you discuss a new problem or manage a chronic condition in the same visit, part of it can be billed as a regular office visit.
Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.
Original MedicareCovered with conditions
Medicare covers a yearly wellness visit at $0, but not a traditional head-to-toe physical.
More details
covers a one-time “Welcome to Medicare” visit and a yearly wellness visit to update your prevention plan. A routine comprehensive physical exam is not covered, and extra tests or problem-focused care can cost you.
Cost: Wellness visit is $0 with an assigning provider; added diagnostic services generally cost 20% after the deductible.
Medicare AdvantageUsually covered
Usually yes: Medicare Advantage covers the wellness visit and many plans add a routine physical.
More details
Plans must cover Medicare’s yearly wellness visit and often add an annual routine physical as an extra benefit. Use an primary care provider.
MedicaidUsually covered
Yes, Medicaid covers preventive checkups.
More details
State Medicaid programs cover preventive visits. Children and teens get full well-child checkups under a federal rule called .

Plan type	How it’s usually covered
Employer or MarketplaceUsually covered	Yes, an annual preventive visit is usually covered at $0 in network. ACA-compliant plans cover preventive visits and recommended screenings without cost sharing. If you discuss a new problem or manage a chronic condition in the same visit, part of it can be billed as a regular office visit. Cost: $0 in network when it qualifies as preventive; follow-up or diagnostic work can have normal cost sharing.
Original MedicareCovered with conditions	Medicare covers a yearly wellness visit at $0, but not a traditional head-to-toe physical. covers a one-time “Welcome to Medicare” visit and a yearly wellness visit to update your prevention plan. A routine comprehensive physical exam is not covered, and extra tests or problem-focused care can cost you. Cost: Wellness visit is $0 with an assigning provider; added diagnostic services generally cost 20% after the deductible.
Medicare AdvantageUsually covered	Usually yes: Medicare Advantage covers the wellness visit and many plans add a routine physical. Plans must cover Medicare’s yearly wellness visit and often add an annual routine physical as an extra benefit. Use an primary care provider.
MedicaidUsually covered	Yes, Medicaid covers preventive checkups. State Medicaid programs cover preventive visits. Children and teens get full well-child checkups under a federal rule called .

What usually has to be true

Use an in-network primary care clinician.
Keep the visit preventive; new complaints may be billed separately.
Frequency limits apply (usually once per plan or calendar year).

Good to know

Labs ordered during a physical may not all be preventive.
Ask the office to code the visit as preventive if no new problem is addressed.

Blood tests & lab work · Blood work, urine tests, and other lab services.
Vaccines · Flu, COVID-19, shingles, pneumonia, tetanus, HPV, and childhood immunizations.
Primary care visit · Office visits with a family doctor, internist, pediatrician, NP, or PA.

Sources

Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.

1
Preventive health services
HealthCare.gov
Most plans must cover specified preventive services without cost sharing when the person meets the recommendation criteria and network rules.
2
Preventive care benefits for adults
HealthCare.gov
Covered adult preventive services include blood pressure, cholesterol, colorectal cancer, depression, diabetes, HIV, hepatitis, and lung cancer screenings, immunizations, PrEP for HIV prevention, tobacco-cessation interventions, and obesity counseling, when criteria are met.
3
Yearly wellness visits
Medicare.gov
Part B covers a yearly wellness visit to develop or update a prevention plan at no cost. It is not a head-to-toe physical; additional tests may have cost sharing.
4
Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
5
Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.
6
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Medicaid.gov
EPSDT requires Medicaid to cover screening, vision, dental, hearing, and all medically necessary services for children and adolescents under 21, even when the state does not cover the service for adults.

General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.

Is annual physical covered by insurance?

What usually has to be true

Good to know

Related

Sources