Medicare preventive services typically come at no cost. These services benefit all people on Medicare, regardless of if they have Medicare Advantage or Original Medicare. Medicare encourages beneficiaries to be proactive with their care by scheduling yearly appointments to prevent significant health risks.
Your Guide to Medicare Preventive Services
Medicare preventive services consist of a multitude of health screenings. These include lab tests, exams, immunizations, health monitoring programs, counseling, and more. During your Annual Wellness Visit and Welcome to Medicare Visit, your doctor reviews the results of these screenings. The Medicare preventive services checklist helps you track your complete and pending services.
While most preventive services are available at no cost to you, any treatment needed following test results is not. Part A and Part B cover treatments, depending on whether the care takes place in an inpatient or outpatient setting.
Medicare covers several types of appointments for preventive services. Beneficiaries use these services to stay on top of their health and receive valuable information from their doctor regarding family health history. Below, we discuss the types of preventive services Medicare covers and how to utilize them.
Welcome to Medicare Visit
The Welcome to Medicare visit is an introductory appointment available to all Medicare beneficiaries within the first year of enrolling. This preventive appointment costs the beneficiary nothing if their doctor or qualified health care provider accepts Medicare assignment.
You can expect your doctor to give you advice and counseling to help you prevent disease, improve your overall health, and discuss ways to stay well.
Annual Wellness Visit
The Annual Wellness Visit is your yearly check-in to discuss your health and wellness with your healthcare provider. This visit is free of charge if you’ve had Part B for at least 12 months and your doctor accepts Medicare.
During this appointment, it is likely that you will also schedule further preventative care based on individual needs assessed by your doctor.
Routine Physical
The preventive exam doesn’t include physical tests such as lung exams and reflexes. But, if there is a symptom that necessitates that kind of screening, Medicare will cover it. Medicare does not cover routine physicals.
So, you will pay 100% of the cost for the exam. The average cost of a routine physical without insurance ranges from $50 to $200, although prices vary.
Medicare’s Preventive Care Service Checklist
Created by the Center for Medicare & Medicaid Services, the Medicare Preventative Services Checklist allows beneficiaries to keep track of the services that should be performed at their preventative appointments.
The checklist provides a list of all preventative services. Keep in mind, not every person will need to complete all the items on the checklist each year. Be sure to speak with your doctor to understand which preventative services are right for you.
What’s On Medicare’s Preventive Services Checklist?
Below are the items CMS provides on their checklist of preventive services Medicare covers.
- One-time Welcome to Medicare Preventive Visit—within the first 12 months you have Medicare Part B (medical insurance)
- Yearly Wellness Visit—get this visit 12 months after your Welcome to Medicare preventive visit or 12 months after your Part B effective date
- Alcohol Misuse Screening and Counseling
- Bone Mass Measurements
- Cardiovascular Disease Screening Tests
- Cervical Cancer Screening
- Counseling to Prevent Tobacco Use
- Depression Screening
- Diabetes Screening
- Diabetes Self-Management training
- Flu-Shot and Administration
- Glaucoma Screening
- Hepatitis B Screening
- Vaccination and Administration for Hepatitis B Prevention
- Hepatitis C Screening
- HIV screening
- Intensive Behavioral Therapy (IBT) for Cardiovascular Disease
- IBT for Obesity
- Lung Cancer Screening
- Mammography Screening
- Medical Nutrition Therapy
- Medicare Diabetes Prevention Program
- Pap Tests Screening
- Pneumococcal Shot and Administration
- Prolonged Preventative Services
- Prostate Cancer Screening
- STI Screening and High-Intensity Behavioral Counseling to Prevent STIs
- Screening Pelvic Exams
- Ultrasound AAA Screening
How to Get Full Coverage for Preventive Services with Medicare
We hope you found this list of Medicare preventive services helpful! Most preventive care services have 100% coverage if your doctor accepts Medicare assignment. However, some diagnostic services require out-of-pocket costs. For situations such as these, Medigap coverage will help with coverage.
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It took me forever to find this page. Previously, I was able to go to MyMedicare for a list of currently eligible Preventative Services. This way I could plan ahead and know which test my doctor could schedule. I just had a Cholesterol blood test and Medicare denied payment. Can’t believe that test is only eligible once every five years. Had no way of knowing this and I’m guessing my doctor wasn’t aware of this also..