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Medicare covers preventive services like health screenings, tests, and vaccines to keep you healthy. These services find health issues early, before they become more serious and costly to treat. 

The preventive services you are eligible for depend on your age, health risk factors, and Medicare-determined time frames. Talk to your doctor or health care provider to find out which preventive services are right for you and how often you need them.

What preventive services does Medicare cover? 

Medicare-covered preventive services include lab tests, exams, vaccinations, and some health monitoring and counseling programs. For a complete list and detailed descriptions of each service, visit’s preventive and screening services page. We cover a few of the common preventive services below. 

Welcome to Medicare Visit. If you are new to Medicare, you are eligible for a one-time preventive visit during your first 12 months of participation in Part B. Your doctor will review your medical and social, health-related  history. You will also get education and counseling about preventive services. 

Yearly Wellness Visit. Once you’ve been on Medicare Part B or have a Medicare Advantage plan for 12 months, you get a free, annual wellness visit. Your primary care doctor or provider will create or update your prevention plan and develop a preventive screening checklist based on your age and health risks. This visit is not a physical exam, which Medicare does not cover.

Vaccines. Medicare Part B covers three vaccines: 

    • A yearly flu shot
    • The COVID-19 vaccine
    • The pneumonia vaccine, given as 2 shots at least one year apart
    • The Hepatitis B vaccine. Medicare Part B pays once for this series of 2-4 shots, 1 to 6 months apart, if you are at medium to high risk or if you have diabetes

View the list of vaccines covered by Medicare Part D.

Mammograms to screen for breast cancer. Medicare covers one baseline mammogram for women between ages 35–39. Women 40 and older are eligible for a screening mammogram every 12 months. 

Prostate cancer screenings. Medicare pays for a prostate-specific antigen (PSA) blood test every 12 months for men aged 50 and older, starting the day after your 50th birthday.

Diabetes screenings. Medicare covers up to 2 diabetes screenings a year if your doctor determines you’re at risk for developing diabetes or have certain risk factors.

What is my cost for preventive services?

Original Medicare. If you have Original Medicare (Parts A & B), Medicare covers 100% of the costs for covered preventive services you are eligible for as long as you get the services from a doctor or provider that accepts Medicare assignment – agrees to accept the payment amount Medicare approves for the service.

Medicare Advantage. Medicare Advantage plans must cover preventive services you are eligible for without charging you deductibles, copayments, or coinsurance, as long as you get the services from in-network doctors or providers.

What preventive services should I get? 

Talk to your doctor or health care provider about the preventive services that are right for you. These services are designed to keep you healthy or catch health issues early, when they are more treatable, so take advantage of the Medicare-covered preventive benefits. 

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American Exchange is a licensed health insurance broker. Robert Huffaker, NPN 13568432

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