Why Preventive Care Matters Under Medicare
Medicare Part B covers a wide range of preventive services at zero cost-sharing — no copay, no coinsurance, and no deductible — as long as you see a provider who accepts Medicare assignment. These services are designed to detect health problems early, when treatment is most effective and least expensive. Yet studies show that many Medicare beneficiaries underutilize these free benefits.
Free Cancer Screenings
| Screening | Frequency | Who Qualifies |
|---|---|---|
| Mammogram (breast cancer) | Once every 12 months | Women 40+ |
| Colonoscopy (colorectal) | Once every 10 years (high-risk: every 2 years) | All beneficiaries 45+ |
| Fecal occult blood test | Once every 12 months | All beneficiaries 45+ |
| Pap smear / pelvic exam | Every 24 months (high-risk: every 12 months) | All women |
| Prostate cancer screening (PSA) | Once every 12 months | Men 50+ |
| Lung cancer screening (low-dose CT) | Once per year | Ages 50-77, 20+ pack-year smoking history |
The colonoscopy benefit has been expanded — if a polyp is found and removed during a screening colonoscopy, Medicare now covers the procedure at the preventive rate (no cost-sharing). Previously, finding a polyp reclassified the procedure as diagnostic, triggering coinsurance.
Cardiovascular Screenings
- Cardiovascular disease risk reduction visit — Annual intensive behavioral therapy with a primary care doctor
- Cardiovascular screening blood tests — Cholesterol, lipid, and triglyceride levels every 5 years
- Abdominal aortic aneurysm screening — One-time ultrasound for men 65-75 who have smoked
- EKG screening — One-time within first 12 months of Part B enrollment
Diabetes Prevention and Management
Medicare covers extensive diabetes-related preventive services:
- Diabetes screening tests — Fasting glucose or A1C, up to 2 per year for those at risk
- Diabetes self-management training (DSMT) — Initial 10 hours of training, then 2 hours of follow-up annually
- Medical nutrition therapy — For beneficiaries with diabetes or renal disease (referred by a physician)
- Medicare Diabetes Prevention Program (MDPP) — Group lifestyle coaching sessions for those with pre-diabetes
Vaccines Covered at $0
Under Part B and Part D combined, Medicare now covers all recommended vaccines at no cost:
- COVID-19 vaccines — covered under Part B at $0
- Flu shot — once per flu season (Part B)
- Pneumococcal vaccine — two shots for most beneficiaries (Part B)
- Hepatitis B — for those at medium-to-high risk (Part B)
- Shingles (Shingrix) — 2-dose series covered under Part D at $0
- Tdap (tetanus, diphtheria, pertussis) — covered under Part D at $0
- RSV vaccine — for adults 60+ (Part D at $0)
Mental Health and Behavioral Screenings
- Depression screening — annually in primary care settings
- Alcohol misuse screening and counseling — annually, with up to 4 brief counseling sessions
- Tobacco cessation counseling — up to 8 sessions per year for smokers
- Obesity screening and counseling — intensive behavioral therapy for BMI 30+
Annual Wellness Visit
The Annual Wellness Visit (AWV) is free every year after your first 12 months on Part B. It is a comprehensive health planning session — not a physical exam — that includes a health risk assessment, personalized prevention plan, cognitive assessment, and advance care planning discussion. See our Annual Wellness Visit guide for details on what to expect.
How to Ensure You Pay $0
To receive preventive services at no cost, you must see a provider who accepts Medicare assignment. If a provider does not accept assignment, they can bill you directly. Additionally, the service must be coded correctly as preventive — if your doctor orders additional diagnostic tests during a preventive visit, those may trigger cost-sharing. Ask your provider to clearly distinguish between the free preventive portion and any diagnostic add-ons.