What to Expect at Your Annual Physical Exam (2026)

Wellness Visit vs. Annual Physical: Know the Difference

This distinction trips people up — and it can affect your insurance bill significantly.

• Annual Wellness Visit (AWV): Under the Affordable Care Act, most health insurance plans must cover a preventive wellness visit at no cost to you (no copay, no deductible) once per year. This visit focuses on preventive care — health history, risk assessments, current medications review, and age-appropriate preventive screenings.
• Annual Physical Exam: A more comprehensive medical examination that includes everything in a wellness visit plus a physical examination of your body systems. Depending on your plan, this may involve a copay or count toward your deductible.

The important caveat: if you bring up a new health problem or symptom during what was scheduled as a wellness visit, the appointment can be reclassified as a medical visit — potentially triggering a copay. Many patients are surprised by unexpected bills because they mentioned a new concern during what they thought was a free visit. Discuss cost implications with your provider's billing team upfront if this is a concern.

What Happens During an Annual Physical

Before the Appointment Begins

• Review of your medical history, family history, and any changes since your last visit
• Medication list review (bring a current list of all medications, supplements, and over-the-counter drugs)
• Lifestyle questions: tobacco use, alcohol consumption, exercise habits, diet, sleep quality, stress levels
• Mental health screening (depression and anxiety screening tools are standard in most comprehensive physicals)

Vital Signs

• Blood pressure measurement
• Pulse/heart rate
• Body temperature
• Respiratory rate
• Height and weight / BMI calculation
• Oxygen saturation (often)

Physical Examination

The hands-on examination component varies by provider but typically includes:

• Head, eyes, ears, nose, and throat (HEENT): Visual acuity, eye health, ear canal and eardrum, throat, lymph nodes in neck
• Cardiovascular: Heart rate, rhythm, murmurs (with stethoscope)
• Respiratory: Lung sounds, breathing pattern
• Abdominal: Organ size, tenderness, bowel sounds
• Musculoskeletal: Range of motion, joint health, posture
• Skin: Lesions, moles, rashes, signs of systemic conditions
• Neurological: Basic reflexes, balance, coordination

Age and Gender-Specific Examinations

Additional examinations are performed based on age and sex assigned at birth:

• Women: Breast exam, pelvic exam (frequency based on age and risk), cervical cancer screening (Pap smear) per current guidelines
• Men: Testicular exam (younger men), prostate screening discussion (men 50+, or 45+ if higher risk)
• All adults 50+: Colorectal cancer screening discussion, bone density screening for women 65+ or those with risk factors

Blood Work: What Standard Lab Tests Include

Your physician will likely order a standard panel of blood tests. What's included varies by age, risk factors, and what's been done recently:

Complete Blood Count (CBC)

Measures red blood cells, white blood cells, and platelets. Helps detect anemia, infection, immune disorders, and certain cancers.

Comprehensive Metabolic Panel (CMP)

Checks kidney function, liver function, blood sugar (glucose), electrolyte balance, and protein levels. Detects diabetes, kidney disease, liver disease, and electrolyte abnormalities.

Lipid Panel (Cholesterol)

Total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. Used to assess cardiovascular risk. Recommended every 4–6 years for adults without risk factors; more frequently if elevated or if you have heart disease risk factors.

Fasting Blood Glucose / HbA1c

Screens for diabetes and prediabetes. HbA1c reflects average blood sugar over the past 2–3 months and doesn't require fasting. Recommended for adults 35–70 who are overweight or obese, or anyone with risk factors.

Thyroid Function (TSH)

Often included, particularly for women and adults with symptoms of thyroid dysfunction (fatigue, weight changes, temperature sensitivity).

Recommended Screenings by Age

Adults 18–39

• Blood pressure screening (every 1–2 years if normal)
• Cholesterol screening (once in early adulthood, then as indicated)
• Diabetes screening (if risk factors present)
• STI screening (as appropriate based on risk)
• Depression screening
• Cervical cancer screening for women (every 3–5 years per current guidelines)

Adults 40–64

• All of the above, more frequently
• Diabetes screening (recommended for overweight/obese adults)
• Lung cancer screening for heavy smokers (ages 50–80)
• Colorectal cancer screening starting at 45 (earlier with family history)
• Mammograms for women (frequency varies by guidelines; discuss with your doctor)
• Bone density screening discussion for women approaching menopause

Adults 65+

• All relevant screenings above
• Bone density (DEXA) scan for women 65+ and men with risk factors
• Fall risk assessment
• Cognitive function screening
• Vision and hearing evaluation
• Abdominal aortic aneurysm ultrasound (men 65–75 who have ever smoked)

Vaccinations to Discuss at Your Physical

Your annual physical is a good time to review your vaccination status:

• Influenza: Annually for most adults
• COVID-19: Per current CDC guidance on updated formulations
• Tdap / Td booster: Every 10 years
• Shingles (Shingrix): Recommended for adults 50+, two doses
• Pneumococcal vaccines: For adults 65+ and those with certain conditions
• RSV vaccine: For adults 60+ or those with risk factors

How to Prepare for Your Physical

• Fast 8–12 hours beforehand if blood work requiring fasting is planned (confirm with your provider)
• Bring a complete, current list of all medications and supplements
• Bring your insurance card and any referrals if required by your plan
• Write down your questions and concerns beforehand — appointments go fast
• Be honest about lifestyle factors (alcohol, tobacco, diet, exercise) — your doctor isn't judging you, they need accurate information to help you
• Bring records of any care you've received elsewhere since your last visit