Annual Physical Exam Cost

Usually administered by a general or family practitioner, the annual physical raleigh north caorlina examination provides a check-up of a person’s overall health.  Despite being a primary reason why healthy men and women visit a doctor, a study in the Archives of Internal Medicine indicated that the cost of the exam could be greater than the benefits due to many preventative screenings or counseling happening at other times during the year.  The American Academy of Pediatrics, however, does advise for children and people ages three to 21 to have a physical performed annually with children under three, requiring visits more often.  Because cost may be prohibitive in a patient’s decision to get a physical, we will investigate some of the costs associated with the annual exams.

Typical Costs Related to an Annual Physical Exam

  • Annual physical exams are covered by most health insurers and many offer it free of charge. For example, the majority of health plans offered by CIGNA and Blue Cross Blue Shield (BCBS), cover the whole price of the annual exam.  The main contributor to cost is the time spent seeing the doctor and using the facility.
  • For patients with insurance but not eligible for a free annual physical exam, most will be responsible for copays of between $10 to $50. Alternatively, some face coinsurance of at least 10%-50%.  The Agency for Healthcare Research and Quality indicates that the national copay average is around $19.  Patients covered under Care First Blue Cross Blue Shield can expect their copay to be $25 whereas patients covered by United One can expect their copay to be $35.
  • Should a patient not have health insurance, they can expect to pay at least $50 to $200 for their annual physical examination. Based on The Medical Expenditure Panel Survey, a group of surveys compiled on the type and price of health care services administered by the Agency for Healthcare Research and Quality, the national average price for a physical is around $199 for a patient without insurance.  In Minnesota’s Park Nicollet Health Services system, for example, the price for an infant’s physical is $169 and $222 for a senior’s physical if uninsured.

What Should be Included

  • An annual physical may include blood pressure and cholesterol screenings, vaccinations, prostate or testicular exams for a man, and PAP Smear breast exams for women. Weight-loss and lifestyle counseling is also frequently provided.
  • For children, the annual physical exam generally focuses on if developmental milestones, such as blood pressure, weight, and height, are being met. A physician may also assess the child’s sleep patterns, exercise habits, diet, and give recommended vaccinations.

Additional Costs

  • While the 2010 Affordable Care Act calls for insurance carriers to cover some preventative services and screenings that patients may get at a physical, plans in existence prior to the act being passed are not required to provide several of these requirements. And depending on the plan, additional tests and services might not be eligible for coverage.


  • For uninsured patients, Heritage providers a comprehensive low cost options, which include physical exams, blood work and PAP Smears. Heritage also provides a yearly membership program, allowing you to significantly reduce the cost of health services at any future visits.
  • No-cost or reduced-cost insurance for children, teens, and adults may be available through Medicaid and the Children’s Health Insurance Program for those who qualify.
  • Large pharmaceutical corporations, like Merck and GlaxoSmithKline, offer patient assistance programs to help those eligible receive free vaccines.
  • Low-income patients without insurance, may be eligible for special programs or discounts through some hospitals or the insurance marketplace. For example, Sutter Health’s hospital network in California offers free care to low-income patients and lower rates for middle-income patients without insurance.
  • As part of Heritage’s uninsured patient assistance program, you are eligible for a host of medical services in one location at a fraction of the cost. Our staff is ready to discuss this program further with you.

More on Annual Physicals : Annual Physical Exam Checklist