Medicare Preventive Services
Medicare covers a range of wellness and preventive services for free to help you stay healthy. Some preventive services include exams, shots, lab tests and screenings. You get a free “Welcome to Medicare” checkup along with annual wellness visits to help prevent disease and disability.
Does Medicare Cover Preventive Services?
Medicare covers a variety of preventive services at no cost to help detect and monitor your health as you age.
Some popular Medicare-covered services include flu shots, mammograms, cancer screenings, diabetes screenings, STD testing and bone density testing.
- Original Medicare (Parts A and B)
- You will not pay a deductible, copayment or coinsurance for most preventive services with Original Medicare. To avoid costs, you must visit a Medicare-participating provider.
- Medicare Advantage
- Similar to Original Medicare beneficiaries, people with Medicare Advantage (Part C) plans will not pay a deductible, copayment or coinsurance for most preventive services. However, you may be charged if you visit an out-of-network provider.
Medicare’s Preventive Services Chart for 2022
Since Medicare covers areas that are considered medically necessary, there is a wide range of preventive services that are available to beneficiaries. Each service varies in terms of how often it can be used.
|Service||How Often You Can Be Checked|
|Alcohol misuse screening and counseling||Once per lifetime|
|Annual Wellness Visit||Annually|
|Bone mass measurements||Every two years|
|Cardiovascular disease screening||Every five years|
|Cervical cancer screening||Every five years|
|Cholesterol testing||Every five years|
|Colorectal cancer screening||Duration varies depending on the specific type of screening and risk level of patient|
|Counseling to prevent tobacco use||Two cessation attempts per year|
|Diabetes screening||Every six months for prediabetic patients and 12 months if previously tested but not diagnosed|
|Diabetes self-management training||10 hours in the initial year and two hours each calendar year after the 10 hours is completed|
|Flu shot||Once per flu season|
|Hepatitis B screening||Once for beneficiaries who don’t meet the high-risk definition and annually for beneficiaries with continued high risk|
|Hepatitis B shot||Two scheduled doses one month apart|
|Hepatitis C screening||Once for patients born 1945 to 1965 not considered high risk and annually for high-risk patients with continued drug injection since the last test|
|IBT for cardiovascular disease||Annually|
|IBT for obesity||Up to 22 visits in a 12-month period|
|Initial preventive physical exam||Once per lifetime|
|Lung cancer screening||Annually|
|Mammography screening||Annually if you are 40 or older|
|Medical Nutrition Therapy||Three hours in the first year and two hours each year after|
|Diabetes Prevention Program||Up to 24 sessions within two years|
|Pap Test Screening||Annually for high-risk beneficiaries and every two years for low-risk beneficiaries|
|Pneumococcal Shot||Timing varies|
|Prolonged Preventive Services||Frequency varies|
|Prostate Cancer Screening||Annually|
|STI Screening||Varies by STI but typically one screening per year for increased risk beneficiaries|
|Pelvic Exam||Annually for high-risk beneficiaries and every two years for low-risk beneficiaries|
|Ultrasound AAA Screening||Once per lifetime|
Exams and Wellness Visits Covered by Medicare
This checkup is different from a standard physical exam. It is an opportunity for your doctor to assess your current wellness, understand your medical history and provide a roadmap for your future care.
It also includes height, weight and blood pressure measurements along with a simple vision test and referrals for screening services.
After your Welcome to Medicare visit, you can get an annual wellness exam every 12 months.
Yearly wellness exams include a health risk assessment, which lets your doctor update your prevention plan and provide you with personalized health advice.
These annual exams also include a cognitive impairment assessment to check for signs of Alzheimer’s disease and dementia.
Lab Tests and Screenings Covered by Medicare
Screenings to detect disease are typically considered preventive if you’ve had no prior related symptoms.
In some cases, Medicare will only cover screenings if you have certain risk factors.
Medicare also covers medically necessary clinical diagnostic lab tests, if ordered by your doctor or practitioner. These lab tests help your doctor diagnose or rule out a potential illness or condition.
Medicare covers screenings for many conditions that affect seniors, including diabetes, cardiovascular disease and different types of cancer.
Medicare will also cover several shots and vaccines, including flu, pneumonia and hepatitis B at no cost to you.
Coverage includes one flu shot per year. Medicare also covers two different pneumococcal shots to protect you from different strains of a bacteria that can cause pneumonia.
Cancer Screenings Covered by Medicare
Medicare covers some screening tests used to find cancer.
It’s important to talk to your doctor about any family history of cancer. This helps health care providers decide which screenings are fit for your needs.
- Breast Cancer
- One mammogram is fully covered by Medicare every 12 months for all women ages 40 and older. Medicare also covers a clinical breast exam once every 24 months.
- Cervical and Vaginal Cancer
- Women who are considered low risk for cervical or vaginal cancers can receive a Pap test and pelvic exam at no cost once every two years. You can get these screenings once a year if you’re at a heightened risk for developing cervical or vaginal cancer.
- Colorectal Cancer
- Medicare covers five different screening tools and tests used to detect colon cancer, including multitarget stool DNA tests, barium enemas, colonoscopies, fecal occult blood tests and flexible sigmoidoscopies. It varies how often you can receive these services at no cost, but Medicare covers all expenses if your doctor accepts assignment.
- Lung Cancer
- Medicare Part B covers lung cancer screenings once a year if you meet several conditions. You must be between the ages of 55 to 77, have no signs or symptoms of lung cancer, currently smoke or quit smoking within the last 15 years and have a written order from your doctor.
- Prostate Cancer
- Medicare covers prostate-specific antigen (PSA) blood tests once a year for men over 50. You pay nothing for this test. Digital rectal exams will cost you a 20% copayment, and your Part B deductible applies.
Other Screenings and Counseling Services
Along with disease and cancer screenings, Medicare provides programs for health monitoring, counseling and education.
These programs and services can help you identify negative behaviors and receive support to form healthier habits.
For example, smokers can receive up to eight tobacco-use cessation counseling visits every year.
Obesity behavioral therapy provides sessions to overweight patients with a body mass index of 30 or higher. It includes a dietary assessment and counseling to help you lose weight using a program focused on diet and exercise.
Frequently Asked Questions About Medicare Coverage for Preventive Services
8 Cited Research Articles
- Centers for Disease Control and Prevention. (2022, January 24). Pneumococcal Vaccination: What Everyone Should Know. Retrieved from https://www.cdc.gov/vaccines/vpd/pneumo/public/index.html
- American Cancer Society. (2019, May 13). Medicare Coverage for Cancer Prevention and Early Detection. Retrieved from https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/government-funded-programs/medicare-medicaid/medicare-coverage-for-cancer-prevention-and-early-detection.html
- AARP. (n.d.). What Is the “Welcome to Medicare” Checkup? Retrieved from https://www.aarp.org/health/medicare-qa-tool/whats-a-medicare-wellness-visit/
- Barry, P. (n.d.). Can Medicare Help Me Lose Weight? Retrieved from https://www.aarp.org/health/medicare-insurance/info-03-2012/medicare-weight-loss-counseling-99.html
- Centers for Medicare and Medicaid Services. (n.d.). Your Guide to Medicare Preventive Services. Retrieved from https://www.medicare.gov/sites/default/files/2021-08/10110-Your-Guide-to-Medicare-Preventive-Services.pdf
- Centers for Medicare and Medicaid Services. (n.d.). Diagnostic Laboratory Tests. Retrieved from https://www.medicare.gov/coverage/diagnostic-laboratory-tests
- Centers for Medicare and Medicaid Services. (n.d.) Preventive & Screening Services. Retrieved from https://www.medicare.gov/coverage/preventive-screening-services
- Centers for Medicare and Medicaid Services. (n.d.) Yearly “Wellness” Visits. Retrieved from https://www.medicare.gov/coverage/yearly-wellness-visits