What Preventive Services Does Medicare Cover?

Medicare Part B covers medically necessary and preventive care services. In an effort to be proactive in caring for the health of beneficiaries, many of these preventive care services are free. Diagnostic tests may involve the Part B copayment of 20% of the Medicare-approved cost for the covered services.

Wellness Visits

One of the first benefits you can take advantage of as a Medicare beneficiary is the “Welcome to Medicare” wellness visit with your doctor. During the first twelve months after you enroll in Medicare Part B, you call your doctor’s office to schedule your Welcome to Medicare visit. During this visit, your doctor will get a comprehensive look at your health by reviewing your medical history, taking measurements, and performing screenings. Your doctor will discuss with you the preventive services they recommend and suggest any counseling you may need.

Every year under Medicare you are covered for an annual wellness visit with your doctor. This is your typical wellness checkup, during which your doctor will update your prevention plan and set you up for any necessary appointments.

Screenings

There are several screenings covered under Medicare. Your eligibility to receive these screenings may depend on your level of risk for the condition, which might be seen in your family history. These screenings are not always covered annually.

Medicare covers a one-time abdominal aortic aneurysm screening for people at risk due to family history or smoking. Part B covers alcohol misuse screening and counseling during your wellness visits. Every two years, Medicare covers a bone density test. You are covered for cardiovascular disease screening every five years and can discuss lowering your risk for cardiovascular disease in what is called a behavior therapy visit each year.

Once each year you are covered for a depression screening, and you are covered for a diabetes screening up to twice per year. People with a BMI of 30 or more are covered for obesity screening and counseling, and people who have diabetes, kidney disease or have had a recent kidney transplant are covered for nutrition therapy services.

If you are at high risk and your doctor orders the test, you are covered for a Hepatitis C screening test. If you are at high risk for HIV, Medicare covers an HIV screening every 12 months. STI screening and counseling is covered.

Medicare covers colorectal cancer screening, and you may have to pay the Part B coinsurance if polyps are removed. People with a history of smoking are covered for a lung cancer screening. Smoking cessation counseling is covered. Yearly mammogram screenings are covered. Pap tests, pelvic exams, and clinical breast exams are covered every two years. An annual PSA screening for prostate cancer is covered.

Vaccinations

Flu shots, Hepatitis B shots for those at risk, and pneumococcal shots are covered under Medicare. (Vaccination against the virus that causes COVID-19 is also covered during the public health emergency.)

Diagnostic Exams

Some of the preventive services that involve 20% coinsurance include diabetes self-management training, a diagnostic mammogram, a digital rectal exam for prostate cancer, and a glaucoma test if you are at risk.

Are you wanting to learn more about what Medicare covers? Review the handy Medicare & You Handbook that Medicare updates every year, or speak to the trusted Medicare Sharks to learn more about how to maximize your coverage.