What free preventive services does Medicare offer?

Medicare preventive exam

The Affordable Care Act includes several ounces of prevention for Medicare beneficiaries: free wellness exams plus a range of tests, from mammograms and colonoscopies to glaucoma screenings. Other preventive benefits include flu shots and smoking cessation counseling.

It’s not often you can get something for nothing. But the authors of the Affordable Care Act believed that it’s cheaper to prevent illness than to treat it, so they added to Medicare free mammograms, colonoscopies and other preventive services, starting in 2011.

Read about other changes for Medicare beneficiaries under the health reform law.

Many of these tests and medical services used to require a co-payment from the patient, but not anymore. Here’s a list of the freebies. (Find more details in the Medicare & You Handbook. The publications should have arrived in the mail when you first signed up for Medicare.)

How well are you prepared to enroll in Medicare? Take the Medicare Smarts quiz.

How well are you prepared to enroll in Medicare? Click the graphic to take our brief quiz.

Some preventive services do include charges for the patient under Medicare Part B (details below). In any case, check ahead of time to be sure your doctor will accept the Medicare payment for the test, as that’s a crucial component of getting your free preventive care (if the doctor doesn’t accept assignment, your preventive care won’t be covered in full).

Wellness visits

  • “Welcome to Medicare” physical exam – A one-time review of your health, education and counseling about preventive services, and referrals for other care if needed. Be sure to get it within 12 months of signing up for Medicare Part B.
  • Yearly “wellness” exam – If you’ve had Part B for longer than 12 months, you can get a yearly wellness visit to develop or update a personalized prevention plan based on your current health and risk factors.

Free tests:

  • Abdominal aortic aneurysm screening, a one-time screening for people at risk (family history of abdominal aortic aneurysms, or you’re a man between 65 and 75 who has ever smoked). Get a referral during your initial Medicare wellness exam.
  • Alcohol misuse screening and counseling
  • Bone mass measurement, or bone density test, which you can get every two years.
  • Cardiovascular disease screening, covered every five years, plus one behavior therapy visit per year (to discuss strategies with your doctor for lowering your cardiovascular disease risk).
  • Depression screening, once per year.
  • Diabetes screening, up to twice per year, for people at high risk of diabetes
  • Flu shots
  • Hepatitis B shots, if you are at medium or high risk.
  • Hepatitis C screening test, for those at high risk whose doctor orders a screening test
  • HIV screening, every 12 months (for people older than 65, screening is only covered if the person is considered high risk)
  • Colorectal cancer screening, which may involve a fecal occult blood test, colonoscopy, flexible sigmoidoscopy and/or barium enema. Copay for doctor visit applies to the blood test and enema.
  • Lung cancer screening for current and former smokers
  • Mammogram each year (screening only; diagnostic mammograms are detailed below, and do include some cost-sharing for the patient).
  • Nutrition therapy services for people who have diabetes, kidney disease, or who have had a recent kidney transplant.
  • Obesity screening and counseling, for people with a BMI or 30 or more
  • Pap test and pelvic exam (including clinical breast exam) every two years, or more often if at high risk.
  • Pneumococcal shot.
  • Prostate cancer screening, including digital rectal exam and PSA test once a year.
  • Sexually transmitted infection screening and counseling. Includes screening tests for Chlamydia, Syphilis, Gonorrhea, and Hepatitis B
  • Smoking cessation counseling

Covered preventive services that include cost-sharing for the enrollee:

  • Diabetes self-management training, for people at risk of diabetes complications. You’ll pay your Part B deductible if you haven’t already met it for the year (in 2018, it’s $183), plus 20 percent of the cost of the training.
  • Diagnostic mammogram (ie, the mammogram has been ordered to diagnose a potential lump or other area of concern, as opposed to a routine screening test when no symptoms are present). You’ll pay your Part B deductible if you haven’t already met it for the year, plust 20 percent of the cost of the screening.
  • Glaucoma test if you are at risk. You’ll pay your part B deductible if you haven’t already met it for the year, plus 20 percent of the cost of the screening. A copay may also apply if the screening is conducted in a hospital outpatient setting.

If you’re enrolled in a Medigap plan, it may pay some or all of the Part B charges incurred for these services.

For more information, see this comprehensive booklet about Medicare’s preventive services.