Preventative healthcare measures like a good diet and regular exercise are important, but so are annual physical exams. Through consistent annual check-ups, many serious conditions and diseases can be caught early.
But what do these annual physical exams entail? Do they vary by gender and more importantly, will your health insurance plan provide coverage? This article provides a detailed overview of everything to expect from your annual physical exams, from how to prepare to questions to ask your doctor.
Annual Physical Exam Quicklinks
- Downloadable Annual Physical Exam Checklist
- Annual Physical Exam Preparation
- Annual Physical Exams For Men
- Annual Physical Exams For Women
- Does Your Insurance Pay For an Annual Physical Exam?
- Annual Physical Exam FAQs
- Annual Physical Exams: A Recap
Downloadable Annual Physical Exam Checklist
Annual Physical Exam Preparation
Generally speaking, a baseline checklist is followed for all annual physical exams. However, depending on family history, recent medical developments, or certain ages, there is a set of routine tests and checks that your doctor will perform.
What does a physical exam entail?
Annual physical exams need to be as comprehensive as possible, as they’re only performed annually. The key points of every exam should include:
- Medical History: reviewing family health history, medication and past treatments, diet and exercise habits
- Vital Signs: recording heart rate, blood pressure, body temperature, respiration rate, and blood oxygen levels and measuring them against average results as well as past results from the patient
- Blood Test: performed to help reveal any underlying health issues that may be more difficult to diagnose
- Visual Exam: a physical assessment of the patient’s skin, eyes, hands, and fingernails
- Physical Exam: an inspection of the patient’s body (checking the heart and lungs with a stethoscope, checking limbs and joints, and inspecting the skin for any dermatological abnormalities)
- Cancer Screening: these screenings are based on factors like sex, current physical condition, your past, and family medical history.
Five questions to ask your doctor during a physical exam
Having an honest, open conversation with your doctor is key to a successful annual wellness exam. Before your appointment, consider asking your practitioner the following questions to make sure you have a crystal-clear understanding of the current state of your health:
- Should I make any lifestyle changes?
- Am I due for any vaccinations or COVID-19 boosters?
- Do I need any additional screenings?
- When and how will I receive my test results?
- Do I need any prescription changes?
Annual Physical Exams For Men
While the main points of the checklist are the same for men and women, annual physical exams for men also focus on checking for prostate disease, abdominal aortic aneurysm, and heart disease.
Prostate exams are included in the physical examination portion of annual exams for men. In addition to a physical examination, an ultrasound exam is also performed, along with a prostate-specific blood test, mid-stream urine test, and a prostate biopsy (if prostate cancer is suspected.)
Abdominal aortic aneurysm
Swelling of the abdominal section of the aorta is 4 times more likely to occur in men, often occurs without any specific symptoms, and can be fatal if left unchecked. These are usually diagnosed during abdominal ultrasound exams, CT scans, and MRI scans.
Heart disease is the leading cause of death among men and often occurs without any symptoms. There are several different types of heart disease, such as atherosclerotic disease, heart arrhythmia, and valvular heart disease. Each type can be diagnosed via electrocardiogram, echocardiogram, and Holter monitor.
Annual Physical Exams For Women
Just like the male-specific exam, there are several diseases that more commonly affect females. Annual physical exam checklists for women include screenings for breast cancer, reproductive system disease, and autoimmune disease.
Like other types of cancer, early detection of breast cancer is instrumental to successful treatment. The most common diagnostic methods include a physical breast exam, mammogram, breast ultrasound exam, and breast biopsy.
Reproductive system disease
Conditions such as cervical cancer, endometriosis, and uterine fibroids can pose a serious health threat to women. An ultrasound exam, hysteroscopy, pap test, and colposcopy identify these conditions.
Autoimmune diseases are often not life-threatening but still require constant monitoring. There are many types of autoimmune diseases, each ranging in symptoms and severity. An antinuclear antibody (ANA) test is typically performed first when a patient is evaluated for autoimmune diseases.
Does Your Insurance Pay For an Annual Physical Exam?
Most insurance plans cover comprehensive wellness visits, not annual physical exams.
Comprehensive wellness visits include checking routine measurements like weight, height, and blood pressure. Annual physical exams are much more extensive and include bloodwork and other tests. Check with your insurance company to confirm your benefits before you make your appointment.
How much do annual physical exams cost?
The cost of an annual physical exam will vary by your coverage, doctor, and location. According to House of Debt, those without coverage may be looking at anywhere from $50 to $200 for an annual physical exam.
Note that this usually only involves a review of medical history and records, general physical evaluation, vitals check, and vision test. If you require a blood panel test, ultrasound, or CT scan, the costs will vary and are not included in the $50-200 price range.
Are annual physical exams covered by Medicaid?
Yes, annual well checks are covered by Medicaid. Also, Medicaid offers screenings for common chronic and infectious diseases and cancers, immunizations, clinical and behavioral interventions to manage chronic disease and reduce associated risks, and counseling to support self-management of chronic disease.
Does Medicare cover annual physical exams?
Per Medicare, if you’ve had Part B medical insurance for longer than a year, you can get a yearly “Wellness” visit.
During your wellness visit, your provider asks you to fill out a questionnaire, called a Health Risk Assessment for a personalized prevention plan. Your visit may also include:
- A review of your current providers, prescriptions, medical and family history
- Height, weight, blood pressure, and other routine measurements
- A schedule for appropriate preventive services, screenings, and shots
- Personalized health advice and advance care planning
- A list of risk factors and treatment options
- A cognitive assessment to look for signs of dementia and Alzheimer’s disease
Does private health insurance cover an annual physical exam?
This depends on your coverage plan. Many health plans may cover preventive services like your annual exam as long as you have an appointment with an in-network doctor. Check with your provider before making an appointment.
Annual Physical Exam FAQs
Do you have to take your clothes off for an annual physical exam?
Yes, but you will be gowned. It’s best not to wear anything constrictive or hard-to-remove to your exam.
Should I fast before my annual physical?
Yes. It’s best to fast for 8 hours prior to an appointment that requires blood work.
What blood work is done yearly?
You can expect two types of blood work: a complete blood count and a metabolic panel. These tests are important for measuring electrolyte levels, liver and kidney function, hydration status, cholesterol, and blood cell values.
Should you shave before an annual physical exam?
Medical professionals understand that hair growth is natural and normal, so there’s no need to shave before your exam.
Can I drink water before my annual physical exam?
Yes. If you’re fasting before blood work, you can drink water and black coffee.
Annual Physical Exams: A Recap
An annual physical exam is an important part of keeping you healthy. In addition, it’s the first step to diagnosing and treating any conditions you may have. If your health insurance doesn’t provide enough coverage for your annual wellness checkup, it’s time to get health insurance quotes from other providers.