Annual Physical Exam: What to Expect, Which Labs You Need and What It Costs
Medically reviewed by Sabeen Munib M.D.An annual physical exam is a yearly preventive visit where your doctor checks your vital signs, reviews your health history, does a physical exam, and orders the screenings and labs that fit your age and risk. Most insurance plans cover it with no copay at an in-network doctor. Any new problem you bring up may be billed separately.
What happens at an annual physical exam?
A yearly physical is mostly a conversation, with a hands-on exam and a plan at the end. Here is what usually happens, in order:
- .Vital signs: blood pressure, heart rate, weight and height, used to work out your BMI.
- .Health history: your medicines and supplements, past illnesses and surgeries, allergies, and any changes in your family history.
- .Lifestyle questions: sleep, food, activity, alcohol, smoking or vaping, and stress.
- .Short screening questionnaires for mood, anxiety and alcohol use.
- .Physical exam: heart and lungs, belly, skin, and other areas based on your age and concerns.
- .Vaccine review: which shots you are due for.
- .A plan: which screening tests and labs are due, and when to come back.
Do women need a pelvic exam every year?
Not always. A Pap or HPV test is done on a schedule, not every year, and a pelvic exam with no symptoms is no longer routine for every woman. If you have pain, unusual bleeding or discharge, or a test is due, it is part of the visit.
Which labs make sense at a physical, and which do not?
More tests are not always better. The right labs depend on your age, your risk factors and the medicines you take. Tests most adults need at some point:
- Cholesterol (lipid panel), to estimate heart and stroke risk
- A1C or fasting glucose, from age 35 if you have overweight, or earlier with other risk factors
- Hepatitis C, once for adults 18 to 79
- HIV, at least once for adults 15 to 65, and more often if you are at risk
- STI tests if you are sexually active and at risk
Tests that are often requested but are not recommended as routine screening in healthy adults with no symptoms:
- Thyroid tests (TSH) with no symptoms
- Vitamin D levels with no risk factors
- A resting EKG for low-risk adults with no heart symptoms
- A large full blood panel every year just to be thorough
These can be the right test when you have symptoms or a reason to check. Testing everyone can lead to borderline results, repeat tests and treatment you never needed. If you are tired, gaining weight or have other symptoms, tell Dr. Munib so she can test for the cause.
Which screenings do you need at your age?
These are the national recommendations for adults at average risk. Family history, smoking or past results can move a test earlier or make it more frequent.
Ages 18 to 39
- Blood pressure at least every 3 to 5 years, and yearly if it is borderline or you are 40 or older
- Cervical cancer screening from 21
- Chlamydia and gonorrhea testing for sexually active women 24 and younger
- One-time hepatitis C and HIV tests
Ages 40 to 49
- Yearly blood pressure
- Mammogram every 2 years for women from 40
- Diabetes screening from 35 if you have overweight
- Colon cancer screening from 45
- Cholesterol and a heart risk estimate
Ages 50 to 64
- Everything above
- Yearly low-dose lung CT from 50 if you have a 20 pack-year smoking history and smoke now or quit within the past 15 years
- Men 55 and older can talk through whether a PSA test makes sense for them
Ages 65 and older
- Bone density scan for women from 65, or earlier after menopause with risk factors
- A one-time belly ultrasound for an aortic aneurysm for men 65 to 75 who have ever smoked
At every age, adults are screened for depression, and adults under 65 for anxiety.
See the full list of preventive screenings and vaccines at The Pur Health
How should you prepare for your physical?
A little preparation makes the visit more useful.
- Bring a list of all your medicines and supplements, with doses.
- Know your family history: heart disease, diabetes, strokes and cancers in parents, brothers and sisters, and the age they were found.
- Bring past lab results, vaccine records and the dates of your last mammogram, Pap test or colon screening.
- Write down your top 2 or 3 questions.
- Wear clothes that make it easy to check your blood pressure.
- Ask before you fast. A cholesterol test and an A1C usually do not need fasting. A fasting glucose test does.
Is an annual physical covered by insurance?
Most health plans cover a yearly preventive visit, recommended screenings and routine vaccines with no copay or deductible when you see an in-network doctor. This is a rule under the Affordable Care Act for most plans. We are in-network with most PPO plans.
The catch is what else you discuss. If you bring up a new or ongoing problem, such as knee pain, a rash or managing your blood pressure medicine, that part may be billed as a separate office visit. Your copay or deductible can apply to it. That is not a billing mistake. Two kinds of care happened in one appointment.
- Ask your plan which labs are covered as preventive.
- Some older (grandfathered) plans do not follow the no-copay rule.
- If you want the visit kept to preventive care only, say so when you book or check in.
How much is a physical without insurance?
A cash-pay visit with Dr. Munib is $190 for new patients and $150 for returning patients. There is no monthly fee. Labs and imaging are paid to the lab or imaging center at their self-pay price, and Dr. Munib orders only what fits your age and risk. HSA and FSA cards are accepted.
Learn how cash-pay visits work at The Pur Health
Sports physicals and checkups for teens 12 and older
Dr. Munib sees teens 12 and older for yearly checkups and for sports and school physicals. A sports physical checks that it is safe to play. A yearly checkup is broader and covers growth, vaccines, mood and private questions. Many families cover both in one visit.
- Book a few weeks before the season so there is time for follow-up.
- Bring the school or league form and your teen's vaccine record.
- Tell us about fainting or chest pain during exercise, or a relative who died suddenly before 50.
- Bring glasses or contacts for the vision check.
When should you not wait for your yearly physical?
A physical is for prevention. Book a sooner visit for new symptoms such as a lump, blood in your stool or urine, weight loss you cannot explain, or a cough lasting more than three weeks. Call 911 for chest pain, trouble breathing, or signs of a stroke such as face drooping or slurred speech.
How Dr. Munib approaches your annual physical
Dr. Munib uses the yearly visit to look at your health as a whole, not to run a fixed checklist. She reviews your history and family risks, decides which screenings are due, and orders labs that answer a real question. If something needs follow-up, such as a high blood pressure reading or an A1C in the prediabetes range, she sets a plan and a date to recheck.
See all primary care services at The Pur Health
Book your annual physical in Irvine
Schedule your yearly physical with Dr. Munib, who has cared for patients in Irvine for more than 15 years, at 114 Pacifica, Suite 280, Irvine. We are in-network with most PPO plans. Cash-pay visits are $190 for new patients and $150 for returning patients. Call (949) 647-5234 or book online.