Medically reviewed by Vanessa Sanchez, MD, Board Certified in Family Medicine at HealthTexas
An annual physical is a yearly appointment with your primary care doctor to check your overall health when nothing is necessarily wrong. Your doctor reviews your history, checks your vital signs, examines you head to toe, orders any lab work or screenings you are due for, and updates your plan for the year ahead. Most visits take 30 to 45 minutes.
The value is not in any single measurement. It is in the pattern. One blood pressure reading tells your doctor very little. Five years of readings from the same practice tells them a great deal. That is the real case for seeing the same primary care doctors in San Antonio year after year instead of only when something hurts.
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What Happens During an Annual Physical Exam
Most annual physicals follow the same shape.
Your history and current medications. Before the exam, your doctor or a member of the care team reviews what has changed since last year: new diagnoses, hospital stays, surgeries, medications you started or stopped, and any conditions that run in your close relatives. Bring an accurate medication list. This is the part patients most often underprepare for, and it is the part that most often changes the plan.
Your vital signs. Height, weight and body mass index. Blood pressure. Pulse and breathing rate. Temperature, and oxygen level when it is relevant.
The physical exam. Your doctor works through the body systems: listening to your heart and lungs, checking your abdomen, examining your skin, looking at your eyes, ears, nose and throat, checking your thyroid and lymph nodes, and testing reflexes, strength and range of motion. Depending on your age and your history, the exam may include additional components, and your doctor will explain each one before it happens. You will usually change into a gown for part of the visit, and you can ask for a chaperone to be present at any point.
The conversation. Your doctor will ask about sleep, diet, exercise, alcohol, tobacco and other substance use, stress, mood and sexual health. These questions are not judgment. They are how risk gets spotted early enough to do something about it. Answer them accurately, even the awkward ones.
What Lab Work Your Doctor May Order
Not everyone needs blood work every year. What gets ordered depends on your age, your medical history, your medications and your risk factors. Common panels include:
- A complete blood count, which looks at red cells, white cells and platelets
- A metabolic panel, which checks kidney function, liver function, blood sugar and electrolytes
- A lipid panel, which measures cholesterol and triglycerides
- Hemoglobin A1C, which reflects average blood sugar over about three months, for patients with diabetes or at risk of it
- Thyroid testing, when your symptoms or history point that direction
If your doctor orders fasting labs, you will usually be asked not to eat for 8 to 12 hours beforehand. Water and most prescription medications are still fine unless you are told otherwise. Ask when you schedule so you are not guessing the morning of.
Which Screenings You Need at Your Age
Screenings look for disease before symptoms start. The U.S. Preventive Services Task Force publishes the recommendations most primary care doctors work from, and they shift with age and risk. In broad terms:
In your 20s and 30s
Blood pressure checks, cholesterol depending on your risk, cervical cancer screening for women starting at age 21, screening for depression, and testing for sexually transmitted infections based on your risk.
In your 40s
All of the above, plus a conversation about breast cancer screening for women, diabetes screening for adults carrying extra weight, and closer attention to heart disease risk.
In your 50s
Colorectal cancer screening, which the Task Force now recommends starting at age 45 for adults at average risk, and lung cancer screening for adults with a significant smoking history.
In your 60s and beyond
Bone density testing, additional heart screening, checks for memory changes and fall risk, and vaccines the CDC recommends for older adults, including shingles and pneumococcal.
Treat that as a map, not a prescription. Your own schedule depends on your history and your risk, and working that out is exactly what the annual visit is for.
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Annual Physical vs. Medicare Annual Wellness Visit
This is a common source of confusion, and it can cost patients money. The two visits are not the same thing.
Medicare Part B does not cover a routine annual physical exam. What it covers is different:
- A Welcome to Medicare preventive visit, available once, within your first 12 months of Part B coverage.
- An Annual Wellness Visit, available every year after you have had Part B for 12 months.
According to Medicare.gov, the Annual Wellness Visit is a health risk assessment and a personalized prevention plan. Your provider reviews your history and medications, checks your height, weight and blood pressure, screens for memory changes, and builds out the schedule of screenings you are due for. It is not a hands-on head-to-toe exam. Patients regularly book one expecting the other.
Many Medicare Advantage plans include a routine physical as an added benefit beyond what Original Medicare covers, but coverage varies from plan to plan. If you are not sure which visit you need, or which one your plan pays for, call your clinic and ask before you book. It takes two minutes and it prevents a surprise.
How to Prepare for Your Annual Physical
A little preparation is what turns a routine appointment into a useful one.
- Bring a current medication list, including over-the-counter medicines, vitamins and supplements, with doses. A photo of the bottles works fine.
- Know your relatives’ health history. Who had heart disease, cancer, diabetes or a stroke, and at roughly what age.
- Write your questions down in advance. Patients reliably remember the thing they meant to ask once they reach the parking lot. Three written questions beat a good memory.
- Ask about fasting when you schedule, not the night before.
- Bring your insurance card and photo ID, and leave time for paperwork. New HealthTexas patients should arrive 30 minutes before the appointment time, and existing patients 15 minutes before.
- Wear something easy to change out of, and skip heavy lotion that morning if an EKG is planned.
What you do not need to do is clean up your habits the week before. Your doctor is not grading you, and an accurate picture is far more useful than a flattering one.
Why You Might Get a Bill for a Preventive Visit
Most plans, including Medicare, cover a preventive visit at no cost to you. Patients still get bills sometimes, and the reason is almost always the same one.
Preventive care and problem care are billed differently. A preventive visit covers screening and prevention when you have no complaint. The moment a new or ongoing problem gets evaluated during that visit, that part of the appointment becomes diagnostic, and your normal cost sharing applies. Mentioning a knee that has been bothering you for three months is enough to trigger it.
That is not a billing error, and it is not a reason to stay quiet about a symptom. It just helps to know going in. If you have something you want looked at, say so when you schedule so the visit gets booked correctly, and ask the front desk what to expect.
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Making Your Annual Physical Count
What makes an annual physical genuinely useful is whether the doctor reading your results has seen your results before. HealthTexas has more than 65 primary care providers across 18 locations in and around San Antonio, and patients see the same provider year after year. Trends get noticed that way. A cholesterol number climbing slowly across four years is visible in a way it never is in a single reading. You can meet our HealthTexas doctors or browse every one of our primary care clinics in San Antonio to find the one closest to you.
If weekday appointments are hard to fit around work, two of our clinics offer Saturday appointments.
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Frequently Asked Questions
What is included in an annual physical exam?
A review of your medical history and medications, vital signs including blood pressure, a head-to-toe physical exam, a conversation about lifestyle and risk factors, any lab work you are due for, and a plan for screenings and follow-up.
How often should I get a physical?
Most healthy adults have one every year. Adults managing a chronic condition such as high blood pressure or diabetes are usually seen more often than that. Your doctor will tell you what makes sense for you.
What should I not do before an annual physical exam?
If fasting labs were ordered, do not eat for 8 to 12 hours beforehand. Otherwise, go easy on hard exercise, alcohol and caffeine that morning, since all three can move your blood pressure reading. Take your regular medications unless you were told otherwise.
Do I have to take my clothes off for an annual physical?
You will usually change into a gown for part of the exam so your doctor can properly check your heart, lungs, abdomen and skin. You can ask about any part of the exam before it happens, and you can request a chaperone at any time.
Are annual physicals still recommended?
There is real debate in medicine about whether every healthy adult needs a yearly head-to-toe exam. What is not debated is the value of staying current on screenings, keeping chronic conditions monitored, and having a relationship with a primary care doctor already in place before something goes wrong. The annual visit is how most adults do all three.
What tests are done at a full checkup?
There is no fixed set. Vital signs are standard. Blood work commonly includes a complete blood count, a metabolic panel and a lipid panel. Screenings depend on your age and your risk factors.
About the Author
Board-Certified Family Medicine physician at HealthTexas
Dr. Vanessa Sanchez, a native of McAllen, Texas, earned her undergraduate and medical degrees from the University of Texas Rio Grande Valley. She completed her Family and Community Medicine residency at UT Health San Antonio and is fluent in Spanish.
Inspired by her family’s connection to healthcare, Dr. Sanchez chose medicine to make a meaningful impact in her community. During residency, she held several leadership roles, including class chair and Administrative Chief Resident. She is passionate about serving diverse communities and providing compassionate, team-based care.