It’s better to prevent an illness than to have to treat it. That’s why regular checkups are essential.
Routinely evaluating your risk factors for various medical conditions, screening for cancer and other diseases, and assessing your lifestyle habits helps you stay healthy while reducing your risk of chronic or life-threatening diseases.
Keep reading to learn more about the benefits of regular checkups with your doctor, how often you should get one, how to prepare for one, and whether they’re covered by insurance.
How often should adults get a checkup?
The recommendations regarding the frequency of routine checkups are based on your age, risk factors, and current health status.
While opinions vary, routine checkups with your doctor are generally recommended as follows:
- once every 3 years if you’re under the age of 50 and in good health
- once a year once you turn 50
If you have a chronic disease, like diabetes or COPD for instance, you should see your doctor more frequently, no matter how old you are.
Your doctor may suggest more or less time between your checkups based on your risk factors, screening test results, and current health status.
What are the benefits of regular checkups?
Regular checkups with your healthcare provider can benefit your health in many ways. Some of the key benefits include:
- finding potentially life threatening health issues early before they cause a problem
- early treatment of health conditions, which increases the odds of a good outcome
- regular monitoring of existing health issues, which lowers the risk of worsening symptoms or severe complications
- staying up-to-date on vaccinations and screening tests
- limiting extra healthcare costs associated with treating complicated or serious conditions that aren’t caught early
- developing and maintaining an open, honest relationship with your primary care physician (PCP)
- learning new ways to live a healthy, longer life and improving your health
What should be included in a checkup?
During your annual checkup, your doctor will review your past health history, evaluate your current health, and schedule appropriate screening tests.
For men and women, an adult annual checkup should include a review and update of:
- your medical history
- your family history, if necessary
- your medication list and allergies
- your vaccination and screening test history
Men and women are typically screened for:
- high blood pressure
- obesity, based on your body mass index
- tobacco use
- alcohol and drug misuse
- HIV screening for adults ages 15 to 65 and anyone at high risk
- hepatitis C for anyone born between 1945 and 1965
- type 2 diabetes for anyone with risk factors or a family history
- colorectal cancer starting at age 50
- lung cancer with a yearly low-dose CT scan for adults ages 55 to 80 who currently smoke or have smoked within the last 15 years
Additional screening tests for women include:
- intimate partner violence screening for women of childbearing age
- a mammogram for breast cancer screening, between ages 50 and 74
- a Pap smear for cervical cancer screening, between ages 21 and 65
- high cholesterol screening, starting at age 45
- osteoporosis screening, starting at age 65
Additional screening tests for men include:
What to expect when you have a physical exam
When you visit your doctor for a routine checkup, the nurse will take you to the exam room and will typically:
- check your blood pressure and other vital signs
- verify your health history, medications, allergies, and lifestyle choices in your electronic medical record
- ask about changes in your medical or surgical history since your last visit
- ask if you need any medication refills
- do screening assessments for depression or alcohol use
When the nurse leaves, you’ll undress, slip on a gown, and sit on the exam table. There may be a sheet on the table so you can cover your lower body if you want to. Your doctor will knock on the door to see if you’re ready before entering the room.
Your doctor will then review the information in your medical record and ask any questions they have based on the information in your record. They may provide counseling on lifestyle choices and screening assessment findings. This is a good time to ask your doctor any of your questions.
Your doctor will then perform a thorough and complete physical exam. This usually includes:
- inspecting your body for unusual growths or marks
- feeling your abdomen and other parts of your body, which allows your doctor to check the location, size, consistency, and tenderness of your internal organs
- listening to your heart, lungs, and intestines with a stethoscope
- using a technique known as percussion, which involves tapping your body like a drum to detect if there’s fluid in areas where it shouldn’t be
- if you’re a woman between the ages of 21 and 65, your doctor may also do a Pap smear during your physical exam
- depending on your age, health risks, and current health status, your doctor may perform other types of exams or tests during your physical exam
After the exam, your doctor will usually talk to you about what they’ve found and will tell you if you need any additional tests, screenings, or treatments. They’ll also talk to you about any medications you may need.
You’ll get dressed when your doctor leaves, and the nurse will give you any necessary prescriptions and instructions before you go.
How to prepare for your checkup
Here are some tips on what you can do to prepare for your physical exam:
- If you’re seeing a new doctor, gather your medical information, including your insurance card, old records, and vaccination history. Take these with you to the appointment. If you don’t have your vaccination history, your doctor can order blood work to test for antibodies in your blood. This is called an antibody titer test.
- If you’ve seen the doctor before, make a list of what’s changed in your medical and surgical histories since your last visit.
- Make sure your medication list is up-to-date and includes any vitamins, supplements, over-the-counter medications, and herbal remedies you’re taking. You may be asked to bring in the actual prescription bottles.
- Make a list of new symptoms, allergies, or medication reactions you’ve had since your last visit.
- Make sure your living will is up-to-date, and bring a copy if there are changes.
- Let your doctor’s office know if you have any special needs, such as an interpreter or a wheelchair, so these services are ready when you get there.
Talking to your doctor
Open and honest communication between you and your doctor is very important when it comes to your health. It allows you to play an active part in your healthcare and helps your doctor provide the best care possible.
Here are some tips on how to communicate well with your doctor:
- Make a list of your questions and any topics you want to discuss with your doctor. Prioritize your questions with the most important ones first.
- If you don’t understand something that your doctor tells you, let them know and ask them to use simple terms.
- If your doctor doesn’t answer your question completely, ask for more information.
- It helps to repeat what your doctor told you. This helps you both know that you understand what your doctor is telling you.
- Take notes while your doctor is talking.
- Ask your doctor what their preferred method of communication is for any follow-up questions after your visit, such as via email or a patient portal.
- If you have a problem hearing your doctor, let them know.
- If you don’t agree with something your doctor has recommended, say so.
- Keep in mind that your doctor can’t share your information without your permission. This may make it easier to talk about uncomfortable or embarrassing topics.
The most important thing is to be open and honest even about subjects that embarrass you or make you uncomfortable. This includes topics such as sexual issues, depression, and drug misuse.
Having accurate and complete information is the only way your doctor can determine the most appropriate treatment plan for you, and help you to the best of their ability.
Are checkups covered by insurance and Medicare?
Because of the Affordable Care Act, Medicare and insurance companies are required to cover preventive services without copayments or deductibles.
However, Medicare and some insurance companies don’t always consider routine checkups to be preventive services. They won’t fully cover the cost of a visit if it includes any tests or services that aren’t considered preventable.
For example, if in addition to prevention services, your doctor evaluates and treats your knee pain that started last week, the visit will be considered a regular visit. In this case, you’ll have a copay and possibly a deductible.
Medicare refers to yearly preventable services like wellness visits. They’re used to create a personalized preventative plan using basic assessments, your medical history, and risk factors.
Immunizations, birth control, and most screening tests are considered preventive, so they’re fully covered by Medicare and all insurance companies.
Lab tests, imaging studies, and tests not used for screening aren’t considered preventive, so you may have out-of-pocket expenses for these.
What if you don’t have a primary care physician?
It’s important to have a primary care physician. Having a primary care physician helps ensure continuity of care and increases the likelihood that you’ll stay current with your screening tests and treatments.
If you have health insurance
These suggestions can help you find a primary care physician who is a good fit for you:
- Get recommendations from friends and family.
- Make sure the doctor is an in-network provider for your health insurance company.
- Get recommendations from your insurance company for in-network providers in your area.
- Do some research and find a doctor who has the same philosophy about health as you do.
- Make sure the doctor isn’t located farther than you’re willing to travel.
- Find a doctor whom you feel comfortable opening up to.
If you don’t have health insurance
In the United States, if you don’t have health insurance or can’t afford healthcare costs, you may want to do the following:
- Contact your local healthcare facilities and ask if they offer discount rates for low-income households or those who are uninsured.
- Find a healthcare facility that offers payment plans you can afford.
- Find community clinics or organizations that offer free or discounted rates for routine checkups.
Several organizations provide affordable healthcare, but they’re not always easy to find, particularly in rural areas:
- Free clinics. If there aren’t any free clinics in your area, look in nearby cities.
- Federally Qualified Health Centers. These community-based facilities provide affordable, accessible high-quality primary care in underserved areas across the country.
- Charity care. This financial aid program covers routine doctor visits in limited areas of the country. They can be difficult to find, but calling your local hospital social worker or large hospitals in your state may help you find this type of care.
- Hill-Burton facilities. Located throughout the country, Hill-Burton facilities are obligated to provide free or reduced-cost care.
Another option is to find low-cost insurance through the healthcare marketplace, which is part of the Affordable Care Act. There, you can find low-cost comprehensive coverage, including preventive care.
Based on your income, financial assistance is available if the insurance is purchased through the healthcare marketplace.
In most parts of the United States, the healthcare marketplace is run by the federal government at HealthCare.gov.
The bottom line
It’s important to take charge and feel empowered about your health. Getting routine checkups is a great way to do that. Regular checkups can help you improve your health and reduce your risk of getting sick.
The recommendations regarding how often you should see your doctor for a checkup are based on your age, risk factors, and current health status. While opinions vary, routine physical exams are generally recommended once a year if you’re over the age of 50, and once every 3 years if you’re younger than 50 and in good health.
If you have a chronic disease or other ongoing health issues, you should see your doctor more often, no matter how old you are.