Preventive Services Covered by Medicare: Stay Healthy Without Extra Costs

Staying ahead of health problems is a top priority for many people on Medicare. Fortunately, Medicare offers a wide range of preventive services; exams, screenings, vaccines, and counseling, designed to help you stay healthy and detect issues early, often with no out-of-pocket cost. Understanding what is covered and how to use these benefits can help you take full advantage of your Medicare benefits and protect your health.

What Are Preventive Services?

Preventive services are health care services that help find health problems early, keep you healthy, or lower your risk of certain diseases. Under Medicare Part B (Medical Insurance), many preventive services are available with no coinsurance or deductible, as long as your provider accepts Medicare assignment.

These services include routine exams, lab tests, screenings, counseling, and vaccinations. Rather than waiting until a health issue becomes serious, preventive care helps you and your doctor build a long-term plan based on your health history, risk factors, and lifestyle.

Key Preventive Services Covered by Medicare

Welcome to Medicare Visit

When you first enroll in Part B, you are eligible for a one-time “Welcome to Medicare” preventive visit within the first 12 months. This visit is not a physical exam in the usual sense. Instead, your healthcare provider will review your medical and social history, check your body mass index (BMI), offer a simple vision test, and talk with you about recommended preventive care such as screenings and vaccinations. There is no cost if your provider accepts Medicare assignment, and the Part B deductible does not apply.

Annual Wellness Visit (AWV)

After your first year on Medicare Part B or after your “Welcome” visit, you can get a yearly wellness visit. During this appointment, you and your provider will create or update a personalized prevention plan. The visit includes a health risk assessment, a review of your medical and family history, and possibly a cognitive assessment. Medicare covers this visit every 12 months, and again, there is no cost-sharing if your provider accepts assignment.

Screenings and Tests

Medicare covers a variety of recommended screenings to help detect disease early, when treatment is most effective. Some of the commonly covered screenings include:

• Cardiovascular disease screening (cholesterol, lipid, and triglyceride levels)

• Bone mass measurements (for osteoporosis)

• Colorectal cancer screenings including colonoscopies and fecal tests

• Cervical and vaginal cancer screenings (Pap tests, pelvic exams)

• Depression screening

• HIV and Hepatitis C screenings for those at risk

• Lung cancer screening for eligible individuals (based on age and smoking history)

Thanks to the Affordable Care Act, many of these services that are rated “A” or “B” by the United States Preventive Services Task Force (USPSTF) are covered without cost-sharing.

Counseling and Behavioral Services

In addition to physical screenings, Medicare covers behavioral services aimed at preventing disease. Medicare offers alcohol misuse screening and counseling. There is also cardiovascular behavioral therapy, designed to help you adopt healthier habits if you have or are at risk for heart disease. Medical nutrition therapy (like counseling for diabetes or kidney disease) is also covered.

Vaccines

Preventive vaccinations are a vital part of staying healthy. Under Part B, Medicare covers several key vaccines at no cost, including the flu shot, pneumococcal vaccines, COVID-19 vaccines, and Hepatitis B shots for those at risk. Note that other vaccines, like shingles or Tdap, may fall under Medicare Part D, depending on your plan.

Why These Services Matter

Preventive care gives you a chance to address health concerns before they become more serious. Having regular wellness visits and screenings helps your doctor identify risk factors early on, such as high blood pressure, diabetes, or signs of cognitive decline. These visits also give you the chance to talk about your personal health goals, your family history, and any lifestyle changes that might help you live more comfortably and independently.

Because many of these services are covered without cost when provided by a Medicare-approved provider, you do not need to delay care because of cost worries. By using these preventive benefits, you are not only protecting your health, you may also be avoiding costlier treatments down the road by catching problems early.

How to Make the Most of Medicare’s Preventive Benefits

Start by talking with your doctor about which preventive services are appropriate for you. Make sure to schedule your “Welcome to Medicare” visit if you are still within the first year of Part B coverage, and then set up your Annual Wellness Visit every 12 months. Bring a list of your family medical history, current medications, and any health concerns to your appointments.

When scheduling, make sure your provider accepts Medicare assignments so you don’t face unexpected out-of-pocket costs. Confirm whether the specific preventive services you need are covered under Part B.

For behavioral services or nutrition counseling, ask your provider about available programs. Many doctors’ offices and clinics offer these preventive services, and they are often easier to access than you might think.

Important Things to Know

Medicare’s preventive services are meant for screening, prevention, and health planning. Not as a substitute for a full physical exam. Unlike an annual physical, wellness visits may not include comprehensive lab tests or a complete physical exam. If your doctor performs additional tests or services during your visit that are not preventive in nature, you may need to pay coinsurance or meet your Part B deductible for those added services.

Medicare does not cover everything. Routine dental, vision, and hearing exams are generally not part of the preventive services covered under Original Medicare. Make sure to verify what preventive services apply to you and how often.

Final Thoughts

Medicare’s preventive services are a powerful tool to help you stay healthy and proactive about your care. By taking advantage of “Welcome to Medicare” visits, yearly wellness assessments, screenings, counseling, and vaccines, you can maintain better health without worrying about extra costs. Talk with your doctor about which preventive services are right for you and make a plan to use your Medicare benefits to their fullest.