Annual Physical Before Year End: Is It Free and What to Ask
Preventive care is often covered at no cost. Book yours before the plan year ends.
This article is general wellness information, not medical advice, and is not a diagnosis or treatment recommendation. Consult a qualified professional before making individual health decisions. Read our full disclosure policy.
Many health plans cover preventive care at no cost when you use an in network provider. That is why the end of the year is a good time to book a checkup. But $0 is not guaranteed in every case, so a short call first can save a bill.
Key takeaways
- Healthcare.gov says most plans cover a set of preventive services at no cost in network.
- Ask how the visit will be billed before you go.
- Many appointments book up in December, so call this week.
How to use the visit before the year ends
- Check your plan year. Many plans reset on January 1. Some do not. Look at your plan documents for the date your deductible resets.
- Call and ask two questions. Ask: "Is this visit billed as preventive?" and "Is this provider in network?" A yes to both is the best sign.
- Know what usually counts as preventive. Healthcare.gov lists services such as blood pressure and cholesterol checks, depression screening, many vaccines, and colorectal cancer screening for ages 45 to 75. Diabetes screening is listed for ages 40 to 70 who are overweight or obese.
- Know what may be billed differently. If you raise a new problem during the visit, part of it may be billed as a regular visit. Ask your doctor to tell you when that happens.
- Bring a short list. Write down your medicines, your family history, and the top three things you want to ask. Three is enough.
- Ask about timing. Ask which screenings you are due for and when. Put the next ones in your calendar so you do not have to remember.
- Book the next one before you leave. Many offices can book a year ahead.
What if I cannot get in this year?
Ask for the earliest slot in January. Ask to be on the cancellation list. If you have other benefits that reset, read our dental and eye benefits article and our prescription refill guide.
What to say at the visit
A short script helps you get more from the time:
- Open with your goal. "I want to make sure I am up to date on screenings and vaccines."
- Mention changes. New medicines, sleep trouble, a family diagnosis, or weight changes are all worth a line.
- Ask what is due next. Get the names and the months, and write them down.
- Ask what a test would cost. If a follow up test is suggested, ask whether it is covered as preventive or billed to your deductible.
- Ask for a summary. Many offices post one in a patient portal. Save it.
Keep it to your top three topics. A focused visit beats a long list that runs out of time.
If your plan year is not January to December
Some employer plans reset in July or October. Then your "year end" is your own reset date, not December 31. Look at your plan summary or member portal, find the date, and book the visit a month before it. The same call script works.
Quick action checklist
- [ ] Find your plan reset date.
- [ ] Call the office and book the visit.
- [ ] Ask whether it is billed as preventive and in network.
- [ ] Write your three questions and your medicine list.
- [ ] Put the booking and next year's reminder in Nusafa.
Not sure which plan you are on? See how to compare health plans by total cost. Subscribe for the next Health piece, on winter hydration.
This is general information, not medical advice. Check with your doctor before major changes.
