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Until Jan. 1 this year, Medicare did not cover any routine exams except for the "Welcome to Medicare" exam for new beneficiaries. The Affordable Care Act created the once-a-year

wellness visit as a new benefit, paying doctors to perform it and making it free to patients. By the end of June, Medicare had paid for nearly 1 million such visits, according to CMS. During

a wellness visit, the doctor measures the patient's height, weight, body mass and blood pressure — and perhaps listens to his heart through his clothes. The rest is a discussion of the

patient's medical and family history, any physical or mental impairments, and risk factors for potential diseases such as diabetes and depression. The doctor also establishes a

schedule for future care, and may refer the patient for other tests and screenings, many of which are now free under Medicare. (See a full list of services covered by the wellness visit.) In

other words, it provides a snapshot of the patient's current health, as a baseline for future yearly visits, and is intended as a preventive service, a way of catching potentially

serious health issues early. "The fact that Medicare is now recognizing the importance of these types of services and is willing to pay for them is a big step forward. That cannot be

overstated," says Ejnes. "A lot of times, the counseling that occurs is more important than the poking and prodding. You're talking about weight, smoking, exercise, screening

for depression. But it's not what we would normally consider a physical. Hence the resistance we're seeing from physicians offering this service and perhaps a sense of

dissatisfaction when the patient leaves and realizes that what they got wasn't what they thought they'd be getting." Among doctors in general, there is no agreement of what

should be done in an annual physical — and some regard it as unnecessary, with no good evidence to show that otherwise healthy patients derive any benefit from it, but even they concede that

most patients like it. TO GET THE FREE CHECKUP Ask the doctor's office _specifically_ for the free Medicare wellness visit or mention the billing code, G0438. Don't just ask for

a physical. If you'd prefer to have a physical, you'll have to pay the doctor's full charge out of your own pocket unless you have secondary insurance such as retiree benefits

from a former employer. Medicare supplemental insurance, also known as medigap, does not cover this cost. Physicians also have varying opinions on Medicare's wellness visit. Some

welcome it as a long overdue opportunity to spend 45 minutes talking with healthy patients to help them stay healthy — or perhaps detect, during the conversation, some sign of an issue that

merits investigation. Research has shown that most doctors don't talk to their patients about weight loss or diet, but when they do take time to discuss it, people often act on it. In

one study, patients who were obese and advised by their doctors to lose weight were three times more likely to try to lose weight than obese people who didn't receive such advice.