How to Differentiate an Annual Wellness Visit vs. Physical Exam

When scheduling their yearly health visits with AdventHealth Primary Care+, most patients refer to this as their annual wellness visit, while others call it their physical exam. Many are surprised when they learn these two visits aren’t the same. Each type has key differences, including the type of care you receive and how it's reflected in insurance coverage.

We’re here to examine each type of visit, including how they differ and which ones you should schedule each year so you can better manage your health.

What is an Annual Wellness Visit?

Through leading-edge techniques and years of research, we’ve learned the importance of preventive medicine, including healthy diets, getting enough sleep, exercising and maintaining a healthy weight. All these lifestyle changes have proven to lower the risk of developing various chronic diseases, such as Type 2 diabetes, cancer and heart disease.

During a wellness visit, your AdventHealth doctor discusses how you’re currently feeling. They may ask you to complete a health risk assessment questionnaire or talk with you directly to gain a baseline of your overall health. When looking at the difference between an annual wellness visit vs. a physical exam, a wellness visit focuses on preventive health.

Previous studies show that wellness visits are important to provide an opportunity for patients to check in with their health care providers for strategies to stay healthy as well as pinpoint any health challenges.

Annual wellness exam services often review:

• Demographic information like age, gender and ethnicity
• Emotional and mental health status, including stress and anxiety
• Immunization/vaccine updates or needs
• Information on your family’s medical history for evaluating genetic disease risks
• Lifestyle habits, including diet, exercise, sleep and alcohol and tobacco consumption
• Medications you take, including over-the-counter drugs and dietary supplements
• Recent medical history, including doctor’s visits, illnesses, ER visits and surgeries
• Social needs, including your current living situation and occupation
• Updated routine health measurements like your weight, height, BMI and blood pressure

After you fill out your questionnaire, your doctor uses it as a guide to address any concerns they may have regarding your health. It’s important to know that some information provided may require additional visits for further discussion with your doctor.

What Is a Physical Exam?

A physical exam is a hands-on assessment your doctor performs to evaluate your health. Previous research shows that about 88% of all diagnoses in primary care can be attributed to a doctor performing a thorough physical exam. This includes the detection of serious conditions like heart disease, various chronic diseases and cancer. A previous study even shows that having an annual physical exam results in a 45% reduced mortality risk.

Physical exams are commonly referred to as an annual checkup. During this exam, your doctor will:

• Check your vitals, including your blood pressure and heart rate
• Evaluate your mental health status, including signs of stress or depression
• Gently tap your abdominal area, checking for tenderness or other issues
• Listen to your lungs and heart with a stethoscope
• Look at your skin, eyes and ears to check for any issues
• Look down your throat and feel for lumps in your neck or lymph nodes
• Measure your height and weight
• Order any laboratory tests or other needed diagnostic screenings
• Talk about your medications, including needed refills
• Test your reflexes and balance

Physical exams for males may additionally include:

• Examination of the penis and testicles to check for lumps or other issues
• Hernia evaluations
• Prostate exams
• Referrals for additional men’s health screenings

For women, physical exams may additionally include:

• Light breast tissue exam to check for abnormal lumps
• Referral for additional women’s health screenings
• Referral to an OB/GYN or a follow-up well-woman exam

You don’t have to wait for your annual physical exam if you have any health concerns. Schedule an appointment with your doctor immediately for the whole-person care you deserve.

Differences Between an Annual Wellness Visit vs. Physical Exam

While both types of visits encourage participation in preventive health, key distinctions exist between them. The biggest difference between your annual wellness visit and a physical exam is that your wellness visit is a discussion about your health with your doctor. In contrast, the physical exam is a hands-on checkup to determine your current health status.

It’s important to note that when it comes to an annual wellness visit vs. a physical exam, there are differences regarding its purpose, procedures and insurance coverages.

Wellness Visit vs. Physical Exam: Purpose and Focus

Wellness visits focus on health risk assessment, overall health planning and preventive medicine. Physical exams focus on comprehensive, hands-on health assessments and diagnosing and treating current health concerns.

Wellness Visit vs. Physical Exam: Insurance Coverage

Most health insurance policies cover one wellness visit a year. However, every insurance company may have different eligibility criteria for coverage. Those with a Medicare Part B plan for at least 12 months receive one yearly wellness visit at no cost.

Most insurance plans cover annual physical exams and require no copays or deductibles. However, coverage and out-of-pocket expenses may differ if you see an in-network doctor or an out-of-network doctor, so it’s important that you review your plan before scheduling an appointment. Additional costs may be added for physical exams if lab tests or diagnostic imaging are required.

Do Patients Need Both Annual Wellness Visits and Physical Exams?

Since wellness visits and physical exams differ, we know you may be wondering if you need both.

While both types of health services serve different purposes, they complement each other in a way that helps improve your overall health. While yearly wellness visits can help assess your health risks, your doctor can’t physically check for anything wrong. Your annual physical exam fills that gap by providing a hands-on exam to address current health issues.

A wellness visit allows you to establish a personalized health plan and learn different lifestyle changes to improve your whole health. Your physical exam allows your doctor to see how your health plan and lifestyle changes are going and recommend anything else that’s needed.

Types of Wellness Visits vs. Physical Exams

It’s important to know that there are different types of wellness visits and physical exams. Types of wellness visits include:

• Adult annual wellness exam
• Medicare annual wellness visit, also known as the Medicare Initial Preventive Physical Exam (IPPE), Initial Annual Wellness Visit (AWV) and Subsequent Annual Wellness Visits for older adults
• Pediatric wellness exams or well-child visits

Types of physical exams include:

• Annual physical exam
• Department of Transportation (DOT) physical exams
• Pre-employment physical exam
• Pre-op physical exam/surgical clearance exam
• School physical exam
• Sports-related physical exam
• Travel-related physical exam
• Well-woman exam

At AdventHealth Primary Care+, we’re here for you, no matter what type of exam you need. Your care is our top priority.

Your Partner in Whole-Person Health

At AdventHealth Primary Care+, we seek to care for all of you in body, mind and spirit. Visit us here to schedule a wellness visit or physical exam. We’re here to help you walk through life feeling whole.