Taking Care of Your Health: Why Yearly Check-ups Matter

It is important to see your primary care provider for a check-up every year. This type of medical appointment should happen when you are feeling well — not when you are sick.

There are different types of yearly check-ups. This resource describes what happens in each one and helps you choose which types may be right for you.

If you need to find a primary care provider, or if you are not insured, you can find tools at the end of this document to help you access the care you need.

What is a Yearly Check-up?

A yearly check-up (also called a wellness visit) with your primary care provider is all about keeping you healthy and catching any health conditions (problems) early, even before you may feel any symptoms. During your visit, your primary care provider may:

Ask about your health, lifestyle, and medications.
Check your weight, blood pressure, or other basic health information.
Talk to you about tests, called screenings, that you may need to catch health conditions early.

Key Terms

Primary care provider (PCP)

A primary care provider (PCP) is a doctor, nurse practitioner, or other health professional who provides your regular healthcare. Your PCP is the person you see when you get sick with a cold, or when you go for your yearly check-up. Your PCP knows your health history and can help coordinate the care you need.

Preventive care

A yearly check-up is one important part of preventive care. Preventive care helps prevent (stop) illnesses before they become serious. At your check-up, you can talk about eating healthy, getting exercise, and avoiding things that can make you sick. You and your care team can also make a plan to get screened for health problems.

Screenings

Screenings are medical tests that check for health conditions before you feel sick or notice any symptoms. If your care team finds a small health problem before it grows, it will be much easier to treat. If you do not have preventive care or get screenings, you may not be able to catch health problems until they are very serious and more difficult to treat. Preventive care keeps you feeling healthy and gives you support to feel your best.

Risk factors

People need some screenings once they turn a certain age, and based on their sex assigned at birth. However, people may need additional screenings if they have certain risk factors for a health condition. Risk factors are things that make a person more likley to get sick with a certain health condition. They can include:

Your family history. Has anyone in your family had this health condition before?
Your daily habits and medications. Are you eating enough healthy food? Are you getting enough exercise? Are you taking any medications or drugs that might put you at risk?

The more risk factors you have for a certain health condition, the more likely you are to experience that condition in the future.

What Screenings Do I Need?

You can find out which screenings are right for you based on your age and sex assigned at birth. Our Screening for All timelines were designed with feedback from people with disabilities, and show a visual chart of common screenings you may need both now and in the future.

Screening Timelines from Screening for All: To open the timelines, visit mcd.org/sfast

If you prefer to type in your age and sex to get a list of screenings you may need right now, you can do that with the MyHealthfinder tool. To open the tool, visit odphp.health.gov/myhealthfinder

If you are still not sure which screenings you need, please talk to your primary care provider.

Avoid Surprise Bills

The purpose of these yearly check-ups is for preventive care only. If you bring up a new health problem, your insurance may not cover it and you could get a bill.

Find your insurance type below to learn which visits should be covered at no cost by your insurance.

If you have Medicaid or Private Insurance, see Medicaid & Private Insurance section.
If you have Medicare Part B, see Medicare section.

Why is Preventive Care Important for People with Disabilities?

Sometimes people with disabilities may experience barriers to receiving preventive care. This is because of gaps in the healthcare system – for example, not all healthcare professionals have been trained to work with people with disabilities, and sometimes accessible medical equipment to do the screenings is not available. Because of these barriers, sometimes health conditions in people with disabilities may go unnoticed or untreated for too long.

Patient story: Andre

Andre (pronouns: they/them), who has cerebral palsy, went to the doctor for their yearly check-up. The doctor did a blood pressure screening and found it was too high. Andre was surprised because they had never noticed symptoms of high blood pressure before. Now, they are working with their care team to manage their high blood pressure and schedule regular check-ups.

Types of Yearly Check-ups

The types of yearly check-ups you get depend on two things: your insurance and your sex assigned at birth. Insurance coverage details vary by plan, provider, and what comes up during the visit. Always confirm with your insurance. When you call to schedule, tell the scheduler what you want out of the appointment. For example: “I want a full physical exam” or “I want bloodwork done.”

Yearly Check-ups Covered by Medicaid & Private Insurance

There are two types of visits covered by Medicaid and private insurance: a yearly physical exam and a well-women exam. You may be able to get both types of visits below in the same year, but you should call to ask your insurance to be sure. You can find a list of Questions to ask Medicaid or Private Insurance later in this document when you are ready to call. But first, let’s learn more about what happens in each type of exam.

Yearly Physical Exam

You can get this exam from your primary care provider (PCP), who will examine your whole body from head to toe.

Insurance coverage information

Medicaid covers a yearly physical in most states.
Most private insurance covers the yearly physical at no cost if your doctor is in-network.
If you have Medicare you can still get a yearly physical, but you may be billed for it unless you have another insurance as well.

What happens at a yearly physical exam

My care team will check my weight, height, and blood pressure.
My care team will review my list of current medications.
My doctor or care team may ask me questions about my mental health.
My care team may give me a vaccine.
My doctor will listen to my heart and lungs.
My doctor will look at my eyes, ears, nose, and mouth.
My doctor may feel my body for any lumps or concerns.
My care team may take a blood sample to check my health.
To avoid surprise billing, ask you primary care provider or health insurance company: “Will the blood test be covered by my insurance, or will I need to pay separately?”
My doctor may refer me for screening tests, like a test to check my large intestine for signs of cancer, a test to check how strong my bones are, or another screening test.
If I have had sex or am having sex, my doctor may recommend testing for HIV and other sexually transmitted infections (STIs). STIs are infections that can spread through vaginal, oral, or anal sex by having sex with someone who already has the infection. I can ask my doctor if I should get tested and how often.
If I bring up a new health concern, such as a rash, pain, or a lump I noticed, I may be billed separately for that visit.

See what a check-up looks like, step by step. Visit tinyurl.com/ssphysical to open a picture-based social story from Boston Medical Center that walks through a physical exam, one moment at a time. Available in multiple languages.

Well-Women Exam (Sometimes Called an Annual Gynecology Exam)

A well-women exam is for women and people assigned female at birth. You can get this exam from your primary care provider (PCP) or from an OB-GYN (obstetrician-gynecologist) — a doctor who specializes in women’s reproductive health. In this exam, your PCP or OB-GYN will check your breast health and the health of your reproductive organs (your uterus, ovaries, and vagina).

If you see your PCP, you may be able to schedule the well-women exam and your yearly physical at the same appointment. Some insurance plans may not cover both visits on the same day, so confirm with your insurance first.

You may prefer to see an OB-GYN for this exam if you have questions about your period, pregnancy, or menopause. Keep in mind that a well-women exam only covers your reproductive and breast health. You will still need a separate yearly physical exam with your PCP to check the rest of your health.

Insurance coverage information

Medicaid covers the well-women exam in most states.
Most private insurance covers the well-women exam at no cost if your doctor is in-network.

What happens at a well-women exam

My care team will check my weight, height, and blood pressure.
My care team will review my list of current medications.
My doctor or care team may ask me questions about my mental health.
My doctor will feel my breasts to check for any lumps or changes.
My doctor will do a pelvic exam to check my reproductive organs, including my uterus, ovaries, and vagina.
My doctor will talk with me about family planning, birth control, my period, sexual health, and preventing infections.
My care team may take a blood sample to check my health.
To avoid surprise billing, ask your primary care provider or health insurance company: “Will the blood test be covered by my insurance, or will I need to pay separately?”
My doctor may refer me for screening tests, like a mammogram to check my breasts for signs of cancer, or a bone density scan to screen for osteoporosis.
If I have had sex or am having sex, my doctor may recommend testing for HIV and other sexually transmitted infections (STIs). STIs are infections that can spread through vaginal, oral, or anal sex by having sex with someone who already has the infection. I can ask my doctor if I should get tested and how often.
If I bring up a new health concern, such as a rash, pain, or a lump I noticed, I may be billed separately for that visit.

Questions to ask Medicaid or Private Insurance

What to expect

Medicaid and most private insurance plans cover a yearly physical and well-women exam. Coverage and costs vary by state (Medicaid) or by plan (private insurance), so it is important to call and check.

How to call

Medicaid: Look on the back of your card or search “[YOUR STATE] Medicaid member services phone number.”

Private insurance: Call the number on the back of your insurance card.

Questions you may want to ask

You may call your insurance if you have questions. Some questions may include:

Is a yearly physical exam covered under my plan?
Is a well-women exam covered under my plan?
Can I get a yearly physical exam and a well-women exam done at the same appointment?
Will I have a copay?
Will blood work be covered, or will I be billed separately?
If my doctor addresses a health concern during my visit, will I be billed separately?
Can I get both a yearly physical exam and well-women exam in the same year?
If you already have a primary care provider: “Is my primary care provider part of my network?”
If you need to find a primary care provider: “Do I need to see a specific doctor or clinic? If so, can you provide a list of primary care providers in my network?”

If you have Medicaid, also ask: Are there any restrictions on which providers I can see?

If you have private insurance, you can also ask: Do I need a referral to see an OB-GYN?

Yearly Check-ups Covered by Medicare Part B

Medicare Part B does not cover a full yearly physical exam, meaning that in these types of appointments, your doctor does not examine your whole body. Instead, the preventive visits covered through Medicare are more like a conversation with your doctor about things you can do to stay healthy.

Medicare has two types of preventive visits, depending on how long you have had Medicare.

Welcome to Medicare Visit (Only in Your First Year on Medicare)

In a Welcome to Medicare Visit, you and your doctor will get to know each other, review your health history, and make a first plan for your care. This must be done in person and only takes place during your first year on Medicare.

What happens at a Welcome to Medicare visit

My doctor will ask me about my health history and my family’s health history.
My care team will review my list of current medications.
My doctor or care team may ask me questions about my mental health.
My doctor will check my weight, height, and blood pressure.
My doctor will check my eyesight.
My doctor and I will make a plan for my preventive care.
If I bring up a new concern, I may be billed separately for that visit or my doctor will schedule a separate appointment.
I can ask to have a physical exam as well, however, there may be a separate charge for this.

Annual Wellness Visit (AWV)

Starting in your second year, you can have an Annual Wellness Visit every year. This is a chance to check in on your health and update your care plan. This can be done in person or by video call.

What happens at an Annual Wellness Visit

My doctor and I will have a conversation about my health.
My doctor will ask me about my health history and my family’s health history.
My care team will review my list of current medications.
My doctor or care team may ask me questions about my mental health.
My care team will check my weight, height, and blood pressure.
My doctor will check my memory and thinking.
My doctor and I will make a plan for my preventive care.
I can ask to have a physical exam as well, however, there may be a separate charge for this.
If I bring up a new concern, I may be billed separately for that visit or my doctor will schedule a separate appointment.

When I call to schedule, I can say: “I would like to schedule my Annual Wellness Visit.”

Questions to ask Medicare

What to expect

Medicare Part B does not cover a full yearly physical exam, but it does cover the Welcome to Medicare and Annual Wellness Visits at no cost. If you have Medicare Advantage, a full physical exam may also be covered, so check your plan.

Get help with your Medicare questions

Call Medicare at 1-800-MEDICARE (1-800-633-4227) to speak with a Medicare representative about your coverage, claims, or account. If you use a TTY device, call 1-877-486-2048.

Chat online. Visit medicare.gov/talk-to-someone to chat with a Medicare representative about your coverage, claims, or account.

Talk to a local counselor. Visit <shiphelp.org to find your State Health Insurance Assistance Program (SHIP). A local counselor can give you free, one-on-one help by phone or in person to understand your options and make coverage decisions. SHIP counselors do not work for Medicare or any insurance company.

Questions you may want to ask

You may call your insurance if you have questions. Some questions may include:

Do I have Medicare Advantage? If so, does it cover a yearly physical exam?
Are there situations where I could be billed for my Annual Wellness Visit?
Will blood work be covered, or will I be billed separately?
If my doctor addresses a health concern during my visit, will I be billed separately?

What To Do If You Need Insurance or a New PCP

If You Do Not Have Insurance

If you do not have insurance, you may still be able to get some preventive services at low or no cost.

Look for a free or low-cost care. Visit findahealthcenter.hrsa.gov to find a community health center near you.

Find free screening programs near you. Visit bit.ly/lowcostscreen to visit Find and Access Preventive Services from MyHealthfinder.

Find more free or low-cost services near you including medical care, food, housing and more by visiting findhelp.org. Enter your zip code to find programs in your area.

If You Do Not Have a Primary Care Provider

Here are some ways to find a primary care provider:

If you have Medicaid: Call the number on the back of your card to ask for doctors in your plan, or visit your state’s Medicaid website to search for a provider. Your plan may ask you to choose a primary care provider.
If you have private insurance: Call the number on the back of your insurance card and ask for a list of doctors in your plan. You can also find doctors in your plan on your insurance company’s website or mobile app.
If you have Medicare: Visit medicare.gov/care-compare to search for a doctor online. You can also call 1-800-MEDICARE (1-800-633-4227). If you use a TTY device, call 1-877-486-2048.
For more ways to find a doctor, including getting recommendations and deciding if a doctor is the right fit, visit Choosing a Doctor: Quick Tips from MyHealthfinder. Visit bit.ly/choosingdr.

Important Questions to Ask a Potential Primary Care Provider

Do you have experience working with patients with disabilities?
Do you have accessible exam tables or equipment?
Can I discuss my accommodation needs before my first appointment?

How to Get Ready for Your Appointment

I can get ready for my appointment by:

I will bring a list of my medications, including name, dosage, reason for taking, and prescribing doctor’s name.
I will bring my insurance card and identification.
I will bring my vaccine record, family health history, and medical diagnoses.
I will let the clinic know if I need accommodations, like extra time, a quiet space, or help filling out forms.

Accommodations You Can Ask For

You have the right to ask for accommodations at your medical appointments. If you need something to feel comfortable — like extra time, a quieter space, or help filling out forms — you can tell the clinic when you call to schedule. You do not have to wait until you arrive.

See a list of accommodations to consider and discuss with your clinic. Visit mcd.org/mhac to review My Healthcare Accommodations Checklist, an interactive PDF.

Patient Story: Janelle

Janelle is autistic and informed the clinic that she needs a low-sensory environment. The staff reserved a room in a quieter area of the clinic with dimmable lights. Janelle felt more comfortable during her visit.

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