Preventive Services Covered by Medicare
Medicare covers many preventive services, often with no cost to you when your provider accepts assignment. Here is an overview of what is available.
The short version
- Medicare Part B covers a "Welcome to Medicare" visit and a yearly wellness visit.
- Many screenings and preventive services have no cost-sharing when providers accept assignment.
- If your doctor provides other services during a preventive visit, you may owe coinsurance for those.
In this guide
Prevention is one of the most valuable parts of your Medicare coverage. Medicare Part B covers a range of preventive services designed to help find health problems early or prevent them. Many are available at no cost to you if your doctor or other health care provider accepts assignment, meaning they agree to accept the Medicare-approved amount as full payment.
Medicare Advantage plans must cover the same preventive services, and many offer them with no cost-sharing as well.
Wellness visits
"Welcome to Medicare" preventive visit. Available once within the first 12 months you have Part B. It includes a review of your medical and social history, basic measurements like height, weight and blood pressure, a simple vision test, a review of your risk for depression, and education and referrals for other preventive services.
Yearly "Wellness" visit. After you have had Part B for more than 12 months, you can get a yearly wellness visit to develop or update a personalized prevention plan. It includes a review of your health history, medications, and a check for cognitive changes, along with a schedule for recommended screenings.
The wellness visit is not the same as a head-to-toe physical exam. If your doctor performs additional tests or services during the same visit, you may owe coinsurance or a deductible for those services.
Examples of covered preventive services
Coverage depends on factors like age, risk and frequency limits. Examples include:
- Abdominal aortic aneurysm screening (one-time, for those at risk)
- Alcohol misuse screening and counseling
- Bone mass measurements
- Cardiovascular disease screenings (blood tests)
- Cardiovascular behavioral therapy
- Colorectal cancer screenings
- Depression screening
- Diabetes screenings
- Diabetes self-management training
- Glaucoma tests (for people at high risk)
- Hepatitis B and C screenings (for those at risk)
- Lung cancer screening (for certain people with a history of smoking)
- Mammograms
- Cervical cancer screening and pelvic exams
- Obesity behavioral therapy
- Prostate cancer screening
- Tobacco use cessation counseling
- Many vaccines, including flu and pneumococcal shots under Part B
The Medicare.gov preventive services page lists each service, how often it is covered and any cost details.
How to make the most of preventive benefits
- Schedule your yearly wellness visit. Put a reminder on your calendar.
- Ask which screenings are due. Your doctor can create a checklist for the next five to ten years.
- Confirm your provider accepts assignment to avoid unexpected costs.
- Ask before extra tests. If your doctor suggests additional tests during a wellness visit, ask whether they are considered preventive or diagnostic.
- Bring your health information, including medications, family history and records from other doctors.
Preventive vs. diagnostic
A screening test done when you have no symptoms is generally considered preventive. If a test is done because you have symptoms, or to follow up on an abnormal result, it may be considered diagnostic, which can involve cost-sharing. For example, a colonoscopy that begins as a screening may involve coinsurance if a polyp is removed. Ask your doctor and check Medicare.gov for details.
Keeping track
Medicare.gov and your online Medicare account can show which preventive services you are eligible for. Keeping your own record of dates and results helps too.
Terrameritavi is an independent publication and is not affiliated with Medicare or any government agency.
