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Routine Physicals

Q. Can I get routine physical checkups under Medicare?

A.  It depends whether you get your benefits from traditional Medicare or a Medicare private health plan. (Learn more about the differences between the two programs.) Traditional Medicare doesn’t currently cover routine checkups. The exception is the “Welcome to Medicare” physical exam that you can get only within 12 months of joining Medicare Part B, which covers doctors and outpatient services. You pay 20 percent of the cost of this one-time exam, which does not cover lab tests. Your Part B deductible is not applied to the cost of the exam, as explained here.

Medicare private health plans generally cover one routine physical exam per year. Most plans charge no copayment for the exam, as long as you go to a physician in the plan’s network of providers. Others plans typically charge $10 to $35 per exam.

Patricia Barry is a senior editor at the AARP Bulletin.

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