Questions to ask at your annual physical

A yearly checkup is the rare appointment that is not about a specific problem, which makes it the best chance you get to ask the bigger questions: how am I doing overall, what am I most at risk for, and what should I actually do about it? It is also the easiest visit to waste, because without a plan it becomes a blood-pressure cuff and a see-you-next-year. Most adults miss most of their recommended preventive care. In one analysis, only 8 percent of US adults over 35 had received all the high-priority preventive services they were due for, according to the CDC. Walking in with a short list is how you close that gap. This is the checkup companion to our questions to ask your doctor guide.

The heart of a good checkup is prevention, so ask plainly which screenings and vaccines you are due for at your age. The US Preventive Services Task Force sets the screening schedule most doctors follow: blood pressure for all adults, colorectal cancer starting at 45, mammograms for women 40 to 74, and cervical and lung cancer screening on their own timelines. The CDC sets the adult vaccine schedule, including a yearly flu shot, shingles at 50, pneumococcal at 65, and a tetanus booster every ten years. Your own family history and risks can move those up, so mention them.

Then ask for your numbers, and write them down: blood pressure, cholesterol, and blood sugar or A1C. Knowing them year to year tells you more than any single reading, and it is the kind of thing that is easy to lose track of between visits. Bring a current medication list too, and ask whether anything on it can be simplified or stopped, which is one of the most useful things a yearly review can do.

If you or a parent is on Medicare, there is a distinction worth understanding before the visit, because it surprises almost everyone. The yearly Wellness visit, in Medicare's own words, "is a conversation-based visit with your doctor or other health care provider to create a prevention plan. It isn't a routine physical exam." There is no requirement that the doctor listen to your heart and lungs or lay hands on you at all. Medicare does not cover a traditional head-to-toe physical; it covers this prevention-planning visit, free once every 12 months.

Here is the part that lands as a surprise bill. The wellness visit is free, but the moment you raise a new complaint (a sore knee, a blood pressure you are worried about) the doctor can bill that as a separate office visit that you owe a share of. Medicare says it plainly: if your provider performs additional services that Medicare "doesn't cover under this preventive benefit," you may owe coinsurance and the deductible. The fix is not to stay silent about your health. It is to ask at the start whether something will be billed separately, and, as Medicare itself advises, to book a separate appointment for a specific problem so the wellness visit can stay focused on prevention. Knowing this ahead of time is the difference between a free visit and an unexpected charge.

A good checkup runs on information you often do not have at your fingertips: last year's numbers, what a specialist found, which screenings you have already had, every medication you take. KeptWell keeps all of it in one place. Upload your records and it reads them, keeps your medication list current, and gives you one plain-English summary to bring to the visit, so the hour goes to your health instead of reconstructing your history. Here is how it works, and it is free today, with an honest plan for what comes next.