The Medicare Benefit Most People Forget to Use

Half the value of any health plan is the part you remember to use, and the yearly wellness visit is the piece most people leave sitting on the table.

What the Visit Actually Is

Your yearly wellness visit is not the head-to-toe physical you may remember from your working years. It is a planning conversation with your provider: you review your history and medications, take a few basic measurements, talk through a short cognitive check, and walk out with a written prevention plan built around your age and risk factors.

Think of it less as an exam and more as a yearly tune-up for the decade ahead. Once you have had Part B for more than twelve months, you become eligible for one every twelve months.

What It Costs, and the One Caveat

Here is the part worth understanding before you book. As long as your provider accepts Medicare assignment and the appointment stays a true wellness visit, you pay nothing: no deductible, no coinsurance. The same goes for many preventive screenings, including cardiovascular checks, diabetes screening, bone-mass measurement, and a range of cancer screenings such as mammograms and colonoscopies.

The detail that trips people up: if your provider treats a new problem or orders extra tests during the same visit, that part is no longer preventive, and normal cost-sharing can apply. That is not a reason to skip the visit. It is a reason to ask, before any add-on, whether it falls under the preventive benefit.

If you are in a Medicare Advantage plan, these same preventive benefits apply. Just make sure the provider is in your plan network so the visit stays at no cost.

What is New for 2026

One small addition this year. Starting in 2026, Medicare folded a short physical-activity and nutrition assessment into the wellness visit, and it can be revisited partway through the year. It is a quiet nod to what research has shown for decades: movement and diet protect the years ahead more than almost anything that happens in an exam room. If you have been meaning to ask about either, this is a natural opening.

A Five-Minute To-Do

• Check the date of your last wellness visit. You qualify again twelve months after the last one, to the day.
• Ask for the right visit by name. Request the “Medicare yearly wellness visit,” not a physical. The words matter at the billing desk.
• Bring your medication list and your questions. A few minutes of prep makes the visit far more useful.
• Before any extra test that day, ask whether it is part of the preventive benefit.

Question of the Month

Is the Medicare yearly wellness visit the same as a yearly physical?

Answer. No. A physical is a hands-on, head-to-toe exam, and Medicare does not pay for routine physicals. The yearly wellness visit is a prevention-planning appointment, and it is the one you can have at no cost every twelve months. Asking for the right one by name is what keeps it free.

Make the Most of What You Already Have

You are already paying for these benefits. The clients who get the most from Medicare are simply the ones who use what is there, on a schedule, with someone keeping an eye on the details.

→ Schedule a quick benefits check-in with your MediGap Advisors expert

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Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors

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