Medicare Preventive Services and Screenings
Preventive screenings are important so you can review your current health status and catch potential health problems before they become serious. Also, if you have risk factors for certain diseases, you may benefit from specific screenings recommended by your doctor. Medicare may cover many types of preventive services to help keep you in good shape.
Your Welcome to Medicare visit and annual Wellness visits
Within the first 12 months that you have Medicare Part B, you can get a “Welcome to Medicare” preventive visit. The doctor or health-care provider will review your medical history and:
- Measure your height, weight, and blood pressure.
- Calculate your body mass index.
- Perform a simple vision and hearing test.
- Review your depression risk.
- Review your falls risk and home safety.
- Offer to talk with you about creating advance directives.
- Go over other factors deemed appropriate based on your medical and social history and other clinical standards.
Your doctor may also create a written plan letting you know which screenings, shots, and other preventive services you may need.
Every year, you may get a Wellness visit to develop or update a personalized health plan. At this annual visit, your doctor may review your medical history and measure your height, weight, and blood pressure, among other preventive screenings.
Both the initial Welcome to Medicare and annual Wellness visits are covered by Medicare Part B, and you pay nothing if your doctor accepts assignment. If additional tests or services are performed, you may have cost-sharing, and the Part B deductible may apply.
Types of Medicare preventive screenings available to all beneficiaries
Some preventive services are available to most Original Medicare, Part A and Part B beneficiaries. You may need to pay the Part B deductible, and some preventive services may have cost sharing. You can check the Medicare website or call 1-800-MEDICARE (TTY users 1-877-486-2048), 24 hours a day, seven days a week, for information on how a specific procedure is covered.
These are some common preventive services available to people with Medicare Part B:
- Cardiovascular disease screenings: blood tests for cholesterol, lipid, and triglyceride levels every 5 years. The tests have no cost if the doctor accepts assignment.
- Cervical and vaginal cancer screenings: a Pap test and pelvic exam to check for cervical and vaginal cancer once every 24 months for all women, or once every 12 months for women who are at high risk. The test and exam have no cost if the doctor accepts assignment.
- Colorectal cancer screenings: several types of colorectal cancer screening tests for those ages 50 or older and for people at high risk. Most of these tests have no cost if the doctor accepts assignment, but some may have cost-sharing.
- Depression screening: one per year. The screening has no cost if the doctor accepts assignment.
- Mammogram: a screening mammogram to check for breast cancer once every 12 months for women 40 or older. The screening mammogram has no cost if the doctor accepts assignment.
- Prostate cancer screenings: a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 months for all men over 50. The exam has cost-sharing, and the Part B deductible applies. The PSA test has no cost if the doctor accepts assignment.
- Flu shot: one per flu season. The shot has no cost if the doctor or health-care provider accepts assignment.
- Pneumococcal shot: a vaccine to help prevent diseases like pneumonia. The shot has no cost if the doctor or health-care provider accepts assignment.
Types of Medicare preventive screenings available if you are at risk
If your doctor or health-care provider determines that you are at high risk for a certain disease or condition, you may be eligible for additional preventive screenings or more frequent screenings. These often require a referral from your doctor.
Some Medicare Part B preventive services covered and recommended for high-risk groups are:
- Abdominal aortic aneurysm screening: a one-time abdominal aortic aneurysm ultrasound for those at risk. This test has no cost if the doctor accepts assignment.
- Bone mass measurement: this test helps to see if you’re at risk for broken bones or osteoporosis, once every 24 months, for qualified people. The test has no cost if the doctor accepts assignment.
- Diabetes screenings: tests to check for diabetes if you have certain risk factors. These tests have no cost if the doctor accepts assignment.
- Glaucoma test: a glaucoma test once every 12 months for people at high risk. This test has cost-sharing, and the Part B deductible applies.
- HIV (human immunodeficiency virus) screening: an HIV screening once every 12 months for those at risk. The test has no cost if the doctor accepts assignment.
- Sexually transmitted infections screening: tests for chlamydia, gonorrhea, syphilis, and/or Hepatitis B once every 12 months for people who are at increased risk. These tests have no cost if the doctor accepts assignment.
- Hepatitis B shot: a shot for people at high or medium risk. The shot has no cost if the doctor or health-care provider accepts assignment.
Whether you’re in excellent health or you’re in a high-risk group, make sure to talk to your doctor about the types of Medicare preventive screenings available to you.