The Welcome to Medicare visit itself does not include any laboratory tests. This surprises many new enrollees, but the visit is structured as a comprehensive health review and physical exam, not a blood work appointment. That said, your provider will likely order preventive lab tests during or after the visit, and Medicare covers several of these screenings separately at no cost to you.
What the Visit Actually Includes
The Welcome to Medicare visit, formally called the Initial Preventive Physical Examination (IPPE), is available once during your first 12 months of Medicare Part B coverage. It covers a detailed review of your medical, surgical, and family history, along with your current medications, supplements, diet, physical activity, alcohol and tobacco use, and social engagement.
The physical exam portion includes measurements of your height, weight, body mass index, blood pressure, balance, and gait, plus a visual acuity screening. Your provider will also screen for depression using a standardized tool, assess your fall risk, evaluate your ability to handle daily activities, and check for hearing impairment and home safety concerns. If you have a current opioid prescription, your provider will review it and discuss non-opioid treatment options.
At the end of the visit, you receive a brief written plan (essentially a checklist) outlining the preventive screenings and services you should schedule going forward. This is where lab work enters the picture.
Lab Tests Ordered Alongside the Visit
While no blood draws are baked into the IPPE billing code, your provider will typically order preventive labs that Medicare covers as separate benefits. These are the most common ones:
- Cardiovascular screening blood tests. Medicare covers a panel that checks your cholesterol, lipid, and triglyceride levels to assess heart attack and stroke risk. This is covered once every 5 years with no cost to you.
- Diabetes screening. If your provider identifies risk factors, Medicare covers up to 2 diabetes screening tests per 12-month period. Covered options include a fasting blood glucose test, a glucose tolerance test, and (as of 2024) a hemoglobin A1C test.
- Colorectal cancer screening. For patients 45 and older, Medicare covers stool-based lab tests including the fecal immunochemical test (FIT) once a year and the stool DNA test (FIT-DNA) once every 3 years. Your provider may discuss or order one of these during the visit.
Because these labs are billed as their own preventive services, they are generally covered without a deductible or coinsurance. They just happen to be ordered at the same time as your IPPE.
Other Screenings You May Be Referred For
The visit also generates referrals for non-lab screenings. The most notable is a once-in-a-lifetime screening electrocardiogram (EKG), which checks your heart’s electrical activity. The EKG does require a referral from the IPPE, and unlike most preventive services, the Part B deductible and coinsurance are not waived for it.
If you’re considered at risk for an abdominal aortic aneurysm, your provider can refer you for a one-time ultrasound screening. You qualify if you have a family history of the condition, or if you’re a man aged 65 to 75 who has smoked at least 100 cigarettes in your lifetime.
What Could Cost You Extra
The IPPE visit itself is covered at no cost under Part B. But if your provider performs additional tests or services during the same appointment that fall outside the preventive benefit, you may owe coinsurance and the Part B deductible may apply. If the extra service isn’t covered by Medicare at all (a routine physical exam, for example), you could be responsible for the full amount.
This is a common source of unexpected bills. A visit that starts as a Welcome to Medicare exam can shift into a diagnostic visit if your provider addresses a new complaint or orders tests that aren’t classified as preventive. Ask before the appointment what will be billed separately so there are no surprises.
How This Differs From the Annual Wellness Visit
The IPPE is a one-time benefit in your first year of Part B. After that, you become eligible for Annual Wellness Visits (AWVs), which focus on updating a personalized prevention plan, tracking cognitive function over time, and reviewing your health risk assessments. The AWV does not include a hands-on physical exam the way the IPPE does, and it does not come with the one-time EKG referral. Both visits, however, serve as a launching point for ordering the same separately billed preventive lab screenings like cardiovascular and diabetes blood tests.
You can have both the IPPE and your first AWV, but not in the same 12-month period. If you use your IPPE in month 6 of Part B, you would need to wait until at least month 13 to schedule an AWV.