Because I'm in America, I get to see the actual bills for the blood tests done at routine annual medicals. It comes out to several hundred dollars (this year, 776 dollars for that single phial of blood), even without the HbA1c -- which my doctor's surgery does not do unless the BG test is high. If these tests are done as part of the annual "wellness" medical they are fully covered by my health insurance.
What happened to me is that I skipped six annual "wellness" checks in a row (my fault -- the surgery sent me letters annually reminding me that this was A Good Idea and entirely covered by insurance). When I finally bothered to turn up in February of this year, the BG check was through the roof. My doctor then ordered an HbA1c, which used to be routine, but is now done only if BG is high. (BTW the A1c was then billed at an additional 71 dollars, added to the 776 dollars for all the other blood tests.) Once again, I did not pay a single penny, it was all covered by insurance.
The diabetes issue is tricky. For those with Type 2, it is insidious because you can have it for years, and it can be quietly ruining your health, with no symptoms. It is just conceivable that I had it for six years prior to diagnosis (my HbA1c in 2009 at the previous check was 5.5% or 37). Or, maybe I only had it for a few months before diagnosis in February 2017.
As a diabetic, I now feel it imperative that anyone having a "regular medical" should automatically get an HbA1c test!!!! Diabetes, in particular Type 2, is such a common disease nowadays (and has such serious implications) that I really don't understand why it would not be tested for.
Coming back to
@Guzzler's point, my doctor (for whom I have a lot of respect) was not worried about me (pre-diagnosis) because he had stereotyped me as "not overweight" although this year he had flagged my file as "need to rule out hyperglycemia" due to that 5.5% A1c in 2009. As it turned out, he was unable to rule it out -- he was forced to "rule it in" sadly.