Wellness Visit vs. Physical

A wellness visit and a physical exam are not the same thing. A wellness visit focuses on preventing future health problems. A physical exam checks your current health from head to toe. Both are important, but they serve different purposes, cover different things, and are billed differently by your insurance.

Many people mix up these two visits. In fact, according to a 2025 Aflac Wellness Matters Survey, about 90% of Americans have put off a checkup or screening that could help catch a serious illness early. Part of the reason? Confusion about what these visits actually are and what they cover.

Here at South Florida Med Group in Miami Lakes, we see this mix-up all the time. Patients from Hialeah, Doral, Miami Gardens, and surrounding areas often ask, "Isn't a wellness visit the same as a physical?" The short answer is no. And knowing the difference can save you money and keep you healthier.

This article will break down everything you need to know about a wellness visit vs. physical, including what happens at each one, how insurance handles them, and how to decide which visit you need.

What Is a Wellness Visit?

A wellness visit is a preventive care appointment. Think of it like a planning session for your health. The main goal is to spot risks early and make a plan to keep you healthy in the years ahead.

During a wellness visit, your provider will check basic things like your height, weight, and blood pressure. But the real focus is on talking. You and your provider will discuss your medical history, family history, lifestyle habits, and any risk factors for common diseases like diabetes, heart disease, and certain cancers.

What Happens During a Wellness Visit?

Your provider will ask you to fill out a Health Risk Assessment. This is a short questionnaire about your health, daily habits, and any concerns you may have. Based on your answers, your provider will create or update a personalized prevention plan.

Here is what a typical wellness visit includes:

• Height, weight, and blood pressure checks
• Review of your medical and family history
• A Health Risk Assessment questionnaire
• Depression and cognitive screening
• Review of current medications and supplements
• A personalized prevention plan with recommended screenings
• Discussion about vaccinations you may need
• Counseling on healthy lifestyle habits

What a Wellness Visit Does Not Include

This is where many people get surprised. A wellness visit is not a hands-on physical examination. Your provider will not listen to your heart and lungs, check your reflexes, or press on your belly. There is no blood work or lab testing included as part of the wellness visit itself.

If your provider does perform any extra tests or examines a specific health complaint during the visit, those services may be billed separately. This is a common reason people get unexpected bills after what they thought was a "free" visit.

A wellness visit is covered at no cost under most insurance plans, including Medicare Part B. According to Medicare.gov, you can get one wellness visit every 12 months with no copay or deductible, as long as your provider accepts assignment.

What Is a Physical Exam?

A physical exam, sometimes called an annual physical, is a more detailed, hands-on checkup of your current health. Your provider checks how your body is working right now, from your heart and lungs to your reflexes and joints.

Think of a wellness visit as "How can we keep you healthy?" and a physical exam as "How is your body doing today?" Both questions matter, but they lead to very different types of appointments.

What Happens During a Physical Exam?

A physical exam is more involved than a wellness visit. Your provider will touch, listen, and look at different parts of your body to check for problems. They may also order blood work, lab tests, and other diagnostic tests.

Here is what a physical exam usually includes:

• All the basics from a wellness visit (height, weight, blood pressure)
• Heart and lung examination with a stethoscope
• Checking your eyes, ears, nose, and throat
• Feeling your abdomen for organ issues
• Testing your reflexes and nervous system
• Blood work and lab tests (cholesterol, blood sugar, kidney function)
• Cancer screenings based on age and risk
• Discussion of any current symptoms or health complaints
• Vaccination updates

Why the Physical Exam Matters

The physical exam gives your provider a full picture of your health. Blood work alone can reveal problems you cannot feel, like high cholesterol, early diabetes, or low thyroid function. A hands-on exam can catch things like an irregular heartbeat, a swollen lymph node, or early signs of joint problems.

For adults over 40, annual physicals become even more important. This is the age when risks for heart disease, diabetes, and many cancers start to climb. Regular physicals help catch these conditions early, when treatment works best. For comprehensive primary care in Miami Lakes, South Florida Med Group provides thorough physical exams and preventive care for patients of all ages.

Wellness Visit vs. Physical: Side by Side Comparison

Understanding the differences at a glance can help you plan your appointments wisely.

This table makes one thing clear. A wellness visit and a physical exam cover different ground. You may need both to get a complete picture of your health.

How Insurance Covers Each Visit

Insurance coverage is one of the biggest differences between a wellness visit and a physical exam. Getting this wrong can lead to a surprise bill, and nobody likes those.

Wellness Visit Coverage

Under the Affordable Care Act, most health insurance plans must cover preventive services at no cost to you. This includes your annual wellness visit. Medicare Part B also covers one wellness visit per year with no copay or deductible.

But here is the catch. If you bring up a new symptom or your provider diagnoses a problem during the visit, the appointment may be partly billed as a sick visit or office visit. That means you could owe a copay or deductible for the extra services.

Physical Exam Coverage

Physical exams are handled differently. Medicare does not cover routine annual physicals. However, many private insurance plans and some Medicare Advantage plans do include annual physicals as a covered benefit. Coverage varies by plan, so it is always smart to check with your insurance before scheduling.

The key takeaway? Always tell the front desk exactly what type of visit you want when you call to book. Say "annual wellness visit" or "annual physical" so the office can code it correctly from the start.

Do You Need Both a Wellness Visit and a Physical?

Yes, ideally you benefit from both. A wellness visit sets the stage for prevention. A physical exam checks under the hood to see how things are running right now. Together, they give you and your provider the most complete picture of your health.

Some providers combine elements of both visits into one appointment. However, if you have Medicare, it is important to understand that the wellness visit portion is free, but any physical exam services may come with extra costs.

Who Needs a Physical Exam Every Year?

Not everyone needs a full physical every single year. But certain groups should make it a yearly habit:

• Adults over 40
• People with chronic conditions like diabetes, high blood pressure, or heart disease
• Anyone with a family history of cancer or other serious illnesses
• People taking prescription medications that need regular monitoring
• Adults who have not seen a doctor in over a year

For residents of Miami Lakes, Hialeah, and Doral who want to stay on top of their health, regular checkups are one of the easiest steps you can take. As Stephanie Cabrera, DNP, PMHNP-BC, a double board-certified nurse practitioner and Miami native with over 17 years of healthcare experience, often says, true wellness starts with knowing where you stand.

The Mental Health Connection Many People Miss

Here is something most articles about wellness visits and physicals leave out: your mental health is just as important as your physical health. Both types of visits can play a role in catching mental health concerns early.

During a wellness visit, your provider may screen for depression and cognitive changes. During a physical, blood work can reveal thyroid problems, vitamin deficiencies, or hormonal imbalances that often look and feel like depression or anxiety.

In Florida, nearly 2.9 million adults live with a mental health condition, and over 58% go untreated. This is a staggering gap, especially in a state that ranks 46th in the nation for access to mental health care.

At South Florida Med Group, we take a whole-person approach to care. That means looking at your mind, body, and spirit during every visit. If your provider notices signs of anxiety, depression, or other mental health concerns during a wellness visit or physical, you do not have to go somewhere else for help. Our integrated team is right here.

How to Prepare for Your Next Wellness Visit or Physical

A little preparation goes a long way. Whether you are scheduling a wellness visit or a physical, showing up ready helps you get the most out of your time with your provider.

Before a Wellness Visit

Bring a list of all your current medications, vitamins, and supplements. Write down any family health history updates, like a parent diagnosed with diabetes or a sibling with heart disease. Think about your lifestyle habits and be honest about things like diet, exercise, sleep, and stress. Your provider is not there to judge. They are there to help.

Before a Physical Exam

Do everything above, plus ask whether you should fast before your appointment (many blood tests require fasting for 8 to 12 hours). Bring any recent test results from other doctors or specialists. Write down any new symptoms, aches, or changes you have noticed, even if they seem small.

Questions to Bring to Either Visit

It helps to walk in with a short list of questions. Here are a few good ones:

• Am I due for any cancer screenings?
• Are my vaccinations up to date?
• Should I be tested for diabetes or high cholesterol?
• Are there any lifestyle changes that could lower my risk for disease?
• Is it time to discuss screenings for my age group?

What Age Related Screenings Should You Ask About?

Preventive screenings are a big part of both wellness visits and physicals. Your age plays a major role in which screenings your provider recommends.

Age Group

Recommended Screenings

18 to 39

Blood pressure every 1 to 2 years, cholesterol every 4 to 6 years, depression screening, STI screening based on risk

40 to 49

All of the above plus diabetes screening every 3 years, mammograms for women starting at age 40

50 to 64

All of the above plus colonoscopy every 10 years (or starting at age 45), lung cancer screening for smokers, prostate discussion for men

65 and older

All of the above plus bone density testing, cognitive screening, annual flu and pneumonia vaccines, shingles vaccine

The U.S. Preventive Services Task Force updates these guidelines regularly. Your provider will help you figure out the right schedule based on your personal health and family history.

For a deeper look at what tests to stay on top of, visit our guide on what health tests should be done regularly.

Common Myths About Wellness Visits and Physicals

Let's clear up a few things that trip people up.

Myth: A wellness visit and a physical are the same thing. They are not. A wellness visit is focused on prevention and planning. A physical is a hands-on exam of your current health.

Myth: If I feel fine, I do not need either visit. Many serious conditions like high blood pressure, high cholesterol, and early stage cancer have no symptoms at all. That is exactly why these visits exist, to find problems before you feel them.

Myth: My insurance covers everything at a wellness visit no matter what. Your wellness visit is free only if it stays within the scope of preventive care. The moment your provider addresses a new symptom or orders extra diagnostic tests, you may be billed for those additional services.

Myth: Young people do not need annual checkups. The 2025 Aflac survey found that adults under 60, especially younger women, were among the most likely to skip recommended screenings. Starting healthy habits early makes a real difference.

Myth: Wellness visits are only for people on Medicare. While Medicare covers a specific Annual Wellness Visit, most private insurance plans also cover annual preventive care visits at no cost under the Affordable Care Act.

Why Preventive Care Saves You Money in the Long Run

Skipping your annual visits might feel like it saves you time and hassle. But it often costs more down the road. Catching a problem early, like prediabetes or high blood pressure, usually means simpler and cheaper treatment. Waiting until it becomes a full-blown condition can mean expensive medications, specialist visits, or even hospital stays.

A 2025 Nationwide Retirement Institute report found that 41% of insured Americans have skipped healthcare appointments due to rising costs. But the irony is that skipping preventive care often leads to higher costs later.

Think of it like car maintenance. An oil change costs a lot less than replacing a blown engine. Your body works the same way.

Frequently Asked Questions

Can I get a wellness visit and a physical at the same appointment?

Some providers do combine both into one visit. But keep in mind that the wellness visit portion is usually free, while the physical exam part may come with a copay or extra charges. Always ask your provider and insurance company ahead of time so you know what to expect on your bill.

How often should I get a wellness visit vs. a physical?

Most adults should get a wellness visit once a year. A full physical exam is also recommended annually, especially for adults over 40 or anyone with chronic health conditions. Your provider can help you decide the right schedule based on your age, health, and risk factors.

Will my wellness visit include blood work?

No, a standard wellness visit does not include blood work or lab tests. If your provider orders blood work during the visit, it is considered a separate service and may be billed to your insurance with a copay or deductible. Blood work is typically part of a physical exam.

What if I bring up a health concern during my wellness visit?

If you discuss a new symptom or health problem during a wellness visit, your provider may address it, but that part of the visit can be billed as a separate office visit. To avoid surprise charges, consider scheduling a separate appointment for specific health complaints.

Is a wellness visit really free?

Under the Affordable Care Act, most insurance plans cover your annual wellness visit at 100% with no copay or deductible. Medicare Part B also covers it fully. However, if additional tests, services, or treatments happen during the visit, those extras may not be free.

Final Thoughts

A wellness visit and a physical exam are both important parts of staying healthy, but they are not the same thing. A wellness visit is your chance to plan ahead and prevent problems. A physical exam is your chance to see how your body is doing right now. Together, they give you the best shot at catching issues early and living a healthier life.

South Florida Med Group serves patients across Miami Lakes, Hialeah, Doral, Miami Gardens, Aventura, North Miami, Miramar, Coral Gables, Kendall, and Westchester. Whether you need a wellness visit, a physical, or mental health support, our team led by Stephanie Cabrera, DNP, PMHNP-BC, FNP-BC, is here to help.

Ready to schedule your next visit? Call us at (786) 860-8844 or book an appointment online. We are open Monday through Friday, 10 AM to 6 PM at 16969 NW 67th Avenue, Suite 205, Miami Lakes, FL 33015.

Feel Better. Live Brighter.