Does Insurance Cover Annual Physicals?
Most health insurance plans will cover one annual physical per year at no cost to you, as these are considered preventive services. Plans often cover screenings and vaccines without a copay, even if the deductible is not met. It is always recommended to confirm with your insurer to make sure the visit is coded as preventive rather than diagnostic.
Annual Physical Exams
It is that time of year when you should schedule an appointment with your doctor for your annual physical. You might be unaware that the kind of visit you schedule has financial ramifications.
Annual physicals are more thorough exams that are performed by a doctor. The doctor will visually examine your body, feel, palpate, tap soft-tissue areas, and use a stethoscope to listen to your body’s sounds.
What to expect during your annual physical:
- Keeping track of your height, weight, blood pressure, and other regular measurements.
- A risk assessment for health involves questions you answer about your health.
- An examination of your medical and family history.
- Creating or updating a list of your current prescriptions.
- Examine for signs of memory loss or dementia, as well as depression, anxiety, and stress.
- Discussion of your risk factors and any potential lifestyle changes or treatment options.
- A schedule for screening for appropriate preventive services, as needed.
How Is Medical Care Billed?
While annual physicals are usually covered by insurance, your insurance may not cover all associated costs, such as labs or tests. Most insurance companies cover one annual physical per year.
Annual physicals, once every 12 months, are covered by Medicare without a copay. You may, however, be required to pay a portion of the cost for certain recommended tests or services.
Some commercial insurance plans no longer consider an annual physical if new symptoms or management of an ongoing health problem are discussed. The visit is now considered a sick or chronic condition visit, and co-pays or coinsurance may be required.
Preparing for Your Annual Physical Exam
You can take steps to get the most out of your annual physical.
- Make notes- Write down questions you have for your doctor or any concerns you would like to discuss, and take the list with you. This will help you cover everything you want to know.
- Know your medical history- Has anything changed since your last exam? Let your doctor know of any procedures or immunizations you have had in the last year. Share if you have received a diagnosis of a new condition from another doctor.
- List your medications- Have a record of all the medications and the dosage you take. This might include medicines prescribed by other doctors. If you use any over-the-counter drugs or supplements, let your doctor know about these as well. Your doctor needs to know about everything you are taking.
- Schedule other appointments- It may be helpful to schedule your mammogram, blood work, or other tests before your appointment for your annual physical. If you have your results, you and your doctor can review them in person.
- Other health data- If you monitor your blood pressure or blood sugar levels, use a symptom tracker, or even keep a health diary, bring that information with you. It will help your doctor develop the best understanding of your health.
Dress in comfortable clothes so you can change easily if your doctor wants you to put on a medical gown for your annual physical.
Related Article: What Are the Benefits of Annual Physicals?