What to Expect at Your Annual Physical Exam

Updated March 28, 2026 • 9 min read • By National Healthcare Connect

Only about 32% of American adults get an annual physical. That's a missed opportunity — not because one exam changes everything, but because consistent annual care builds a relationship with a doctor who can notice gradual changes over years that a single urgent care visit never would.

What Happens Before the Exam

When you arrive, a nurse or medical assistant will typically:

• Check your vital signs: blood pressure, heart rate, respiratory rate, temperature
• Measure your height and weight (and calculate BMI)
• Review your current medications and any recent changes
• Ask about allergies
• Update your family medical history (parents, siblings with significant conditions)
• Ask screening questions about mental health, substance use, and lifestyle

The Physical Examination

Your doctor will conduct a head-to-toe assessment that typically includes:

• Head and neck: Eyes, ears, lymph nodes, thyroid gland
• Heart and lungs: Listening with a stethoscope for irregular heartbeat, murmurs, abnormal breath sounds
• Abdomen: Feeling for organ enlargement, tenderness, bowel sounds
• Reflexes and neurological screening: Basic coordination and reflex checks
• Skin: Visual inspection for suspicious moles, rashes, or lesions
• Extremities: Swelling, pulses, range of motion

Bloodwork and Lab Tests

Most annual physicals include a blood draw before or at the appointment. Standard labs typically ordered:

• Complete blood count (CBC): Checks red cells, white cells, platelets — screens for anemia, infection, blood disorders
• Comprehensive metabolic panel: Kidney function, liver function, electrolytes, blood sugar
• Lipid panel: Total cholesterol, LDL, HDL, triglycerides
• Thyroid (TSH): Often added, particularly for women over 50
• Fasting glucose or HbA1c: Diabetes screening, especially if at risk
• Urinalysis: Kidney health, infection screening

Note: Fast for 8–12 hours before your appointment if bloodwork is ordered (water is fine). Ask when scheduling.

Preventive Screenings and Immunizations

Depending on your age, sex, and risk factors, your doctor may order or refer you for:

• Blood pressure: Every visit for adults
• Colorectal cancer screening: Starting at 45 (colonoscopy, stool DNA test, or FIT)
• Mammogram: Starting at 40–45 for women (varies by guideline)
• Pap smear/cervical screening: Every 3–5 years for women 21–65
• Lung cancer screening (LDCT): For current/former heavy smokers 50–80
• Bone density scan (DEXA): Women 65+, or younger with risk factors
• Immunizations: Annual flu shot, COVID booster if applicable, Tdap every 10 years, Shingrix (shingles) vaccine at 50+

How to Make the Most of Your 30 Minutes

The typical annual physical runs 30–60 minutes. Use the time well:

• Write down concerns before you go. "Everything is fine" means missed opportunities. What's bothering you, even vaguely? Note it.
• Bring a complete medication list including supplements and over-the-counter medications.
• Mention family history updates. A parent's new diagnosis of heart disease, cancer, or diabetes changes your risk profile and screening schedule.
• Be honest about lifestyle. Alcohol use, diet, physical activity, sleep — doctors can't help with what they don't know about.
• Ask what screenings are due. Say: "Based on my age and history, what preventive screenings should I have this year?"
• Discuss any mental health concerns. Annual physicals increasingly include depression and anxiety screening — don't minimize what you're experiencing.

Is It Free With Insurance?

Under the Affordable Care Act, preventive services — including annual wellness visits — are covered at 100% with no cost-sharing when you see an in-network provider. However, there's an important distinction:

• Preventive visit (free): Routine physical, screenings, immunizations — covered 100%
• Diagnostic visit (may have cost-sharing): If you discuss a specific problem (knee pain, new symptoms), that may be billed as a separate diagnostic service subject to your deductible and co-pay

If you have concerns to discuss beyond routine wellness, ask your doctor whether that will change the billing. Some practices can split these into separate appointments or handle both on the same day as covered wellness.