Why you might get a doctor’s bill after your free annual physical

Most U.S. health insurance plans pay for an annual wellness check or physical.

By law, a wellness check can include routine immunizations, cancer and depression screenings, and other basic services—at no cost to you. These free visits encourage detection of life-threatening conditions or illnesses.

Still, some patients report getting billed after a wellness check.

What gives?

You can be charged if:

• You’re visiting to treat a chronic condition such as asthma or diabetes. You can be charged a copayment for the office visit. But if you get a flu shot or other routine immunization, the shot is free.
• Your wellness check is provided by a doctor not in your insurance plan’s network. However, if an out-of-network provider is used because there is no in-network provider available, you shouldn’t be charged.
• You get treatment after a screening at your wellness check. For instance, if a CT scan at your wellness appointment detects lung cancer, you’ll have to share the costs of related surgery or medication.

If you get an unexpected bill after a wellness appointment, ask for an itemized bill with billing codes. If something seems off, ask the physician’s office. You can also follow up with your insurance company.

Have an insurance question? Call TDI’s Help Line at 800-252-3439. It’s open weekdays from 8 a.m. to 5 p.m. Central time.

Learn more

• How to save money at the doctor
• You might have gotten the bill by mistake
• How to get help with a surprise medical bill