How to Schedule Your Annual Checkup

What do I say when I call?

Keep it straightforward: say you would like to schedule your annual wellness visit or annual preventive physical. This tells the scheduler to book the right appointment type — wellness visits are typically longer than sick visits. If you have a preference for morning or afternoon (which matters if you need to fast before labs), mention that when you call. If you have a specific clinician you want to see, ask for them by name.

Can I book online instead of calling?

Many practices now offer online scheduling through a patient portal or a booking link. Log in, find the scheduling section, select Annual Physical or Wellness Visit from the appointment type menu, and choose a time. If you are new to the practice, you may need to call first to create your patient account before portal access is granted.

Is the annual visit covered by insurance?

Most ACA-compliant health insurance plans are required to cover preventive services — including a yearly wellness visit — without cost-sharing (no copay, coinsurance, or deductible) when you see an in-network provider 1Ref 1Centers for Medicare and Medicaid Services (2023).Background: The Affordable Care Act's New Rules on Preventive Care.ACA requires non-grandfathered health plans to cover preventive services without cost-sharing including annual wellness visits; services rated A or B by USPSTF must be covered at no cost to enrollees; out-of-network providers and problem-focused services added at a preventive visit may be billed separately. This rule applies to non-grandfathered individual and group health plans.

Covered preventive services for adults include blood pressure screening, depression screening, certain cancer screenings, cholesterol checks, and immunizations — based on recommendations graded A or B by the US Preventive Services Task Force 1Ref 1Centers for Medicare and Medicaid Services (2023).Background: The Affordable Care Act's New Rules on Preventive Care.ACA requires non-grandfathered health plans to cover preventive services without cost-sharing including annual wellness visits; services rated A or B by USPSTF must be covered at no cost to enrollees; out-of-network providers and problem-focused services added at a preventive visit may be billed separately3Ref 3US Preventive Services Task Force (2024).A and B Recommendations.Comprehensive list of evidence-based preventive services graded A or B that ACA-compliant plans must cover without cost-sharing, including blood pressure screening, depression screening, cancer screenings, HIV screening, and immunizations for adults.

A few things to confirm before your visit: - That your provider is in-network (out-of-network preventive visits are not guaranteed free) - Whether the visit will be billed as a preventive wellness visit (not as a sick visit, which typically involves cost-sharing) - If any services added during the visit (like treating an existing condition) may be billed separately 1Ref 1Centers for Medicare and Medicaid Services (2023).Background: The Affordable Care Act's New Rules on Preventive Care.ACA requires non-grandfathered health plans to cover preventive services without cost-sharing including annual wellness visits; services rated A or B by USPSTF must be covered at no cost to enrollees; out-of-network providers and problem-focused services added at a preventive visit may be billed separately

What if I do not have a primary care clinician?

Not having a regular doctor is the most common barrier to booking a checkup. A few options:

• Telehealth platforms like Gale can match you with a primary care clinician for a preventive visit.
• Federally Qualified Health Centers (FQHCs) are community clinics that offer sliding-scale fees for uninsured patients — findahealthcenter.hrsa.gov can locate one near you 2Ref 2Health Resources and Services Administration (2024).Find a Health Center.HRSA funds approximately 1,400 Federally Qualified Health Centers (FQHCs) at 16,200+ sites across all US states and territories; FQHCs provide primary care on a sliding fee scale based on ability to pay for uninsured and underserved patients.
• Urgent care clinics can handle basic physicals if primary care wait times are long.

If you want to establish with a long-term clinician, new patient slots can take several weeks to open. Getting on the list now is better than waiting.

What should I confirm when I book?

A few things worth asking when you schedule:

• Whether fasting is required before the visit (if labs are being drawn, you will typically fast for 9 to 12 hours beforehand)
• Whether the visit will be billed as a preventive visit — this affects what you owe 1Ref 1Centers for Medicare and Medicaid Services (2023).Background: The Affordable Care Act's New Rules on Preventive Care.ACA requires non-grandfathered health plans to cover preventive services without cost-sharing including annual wellness visits; services rated A or B by USPSTF must be covered at no cost to enrollees; out-of-network providers and problem-focused services added at a preventive visit may be billed separately
• Whether new patient paperwork can be completed online ahead of time
• Whether records from a previous clinician need to be sent in advance

The annual wellness visit is primarily a prevention and screening review, not a head-to-toe exam or a sick visit. If you also have a new or ongoing medical concern you want addressed at the same appointment, let the scheduler know — you may need a longer appointment slot, and any problem-focused services may be billed separately from the preventive component 1Ref 1Centers for Medicare and Medicaid Services (2023).Background: The Affordable Care Act's New Rules on Preventive Care.ACA requires non-grandfathered health plans to cover preventive services without cost-sharing including annual wellness visits; services rated A or B by USPSTF must be covered at no cost to enrollees; out-of-network providers and problem-focused services added at a preventive visit may be billed separately.