Key Takeaways

• Medicare supports a wide range of preventive services to help detect serious health conditions early, often before symptoms appear.

• Staying informed about which screenings and wellness visits are covered can empower you to take better control of your long-term health.

Why Early Detection Matters

Catching health problems early often leads to better outcomes, lower treatment costs, and more treatment options. Medicare recognizes this and offers many preventive services to help you stay ahead of potential health risks. Whether you’re monitoring your blood pressure or screening for cancer, Medicare plays a role in keeping you proactive.

What Medicare Covers for Preventive Health in 2025

Medicare Part B focuses heavily on preventive care, helping you access regular screenings and wellness visits with little to no out-of-pocket cost, depending on the service and provider.

Annual Wellness Visit

Every 12 months, you’re eligible for an Annual Wellness Visit. This visit is not a head-to-toe physical, but it provides the opportunity to:

• Create or update your personalized prevention plan

• Review your medical and family history

• Check your height, weight, blood pressure, and other vital signs

• Discuss cognitive function

• Assess risk factors for potential diseases

Initial Preventive Physical Examination (IPPE)

Also known as the “Welcome to Medicare” visit, this one-time appointment must occur within the first 12 months after enrolling in Part B. It includes:

• A vision check

• A review of potential risk factors

• A screening for depression

• A plan for future preventive services

Screenings Covered by Medicare

Medicare covers various screenings that help detect diseases before they become severe. These are either fully covered or come with minimal cost-sharing when you use participating providers.

Cancer Screenings

Medicare includes a broad selection of cancer screening tests:

• Mammograms: Once every 12 months for women aged 40 and older

• Colorectal Cancer Screenings: Includes fecal occult blood tests, colonoscopies every 10 years, and more frequent testing for higher-risk individuals

• Pap Tests and Pelvic Exams: Every 24 months, or every 12 months for those at high risk

• Prostate Cancer Screenings: Includes PSA blood test every 12 months for men over 50

• Lung Cancer Screenings: Annually with low-dose CT for high-risk individuals aged 50–77 who meet smoking history criteria

Cardiovascular Disease

• Cardiovascular Behavioral Therapy: Annually, helps lower risk by promoting healthy habits

• Cholesterol, Lipid, and Triglyceride Testing: Once every 5 years

• Blood Pressure Checks: Part of Annual Wellness Visits and other check-ups

Diabetes-Related Screenings

If you have certain risk factors, Medicare covers:

• Diabetes Screening Tests: Up to twice a year

• Diabetes Self-Management Training: For those with a confirmed diagnosis

• Hemoglobin A1c Tests: Part of managing the disease

Infectious Disease Screening

• Hepatitis B and C Screenings: Based on risk factors and timelines

• HIV Screening: Once every 12 months for individuals aged 15–65 or those at increased risk

• Sexually Transmitted Infection (STI) Screening and Counseling: Annually for at-risk individuals

Vaccinations

Preventive immunizations are essential, especially in older age. Medicare covers:

• Influenza Vaccine: Annually

• Pneumococcal Vaccine: Typically one or two shots in a lifetime

• Hepatitis B Vaccine: For medium or high-risk individuals

• COVID-19 Vaccine: Based on current CDC recommendations

Mental Health and Cognitive Screenings

Medicare includes preventive mental health support to detect issues like depression and cognitive decline.

Depression Screening

• Annual screening is covered during a primary care visit.

• Helps identify early signs of mental health changes.

Cognitive Assessment

• Included in Annual Wellness Visits or separate appointments

• Evaluates memory, decision-making, and language comprehension

Obesity and Nutrition-Related Preventive Services

Maintaining a healthy weight and diet is crucial to overall wellness. Medicare provides tools to help.

Obesity Behavioral Therapy

• If your Body Mass Index (BMI) is 30 or more, Medicare covers behavioral therapy sessions.

• Sessions focus on weight loss strategies, dietary improvements, and physical activity.

Medical Nutrition Therapy (MNT)

• Covered for those with diabetes or kidney disease

• Includes nutritional assessment and counseling

Preventive Services Based on Risk

Some services depend on whether you are considered high-risk based on your personal or family health history, age, or other conditions.

Bone Mass Measurement

• Covered every 24 months for individuals at risk for osteoporosis

• More frequent testing allowed if medically necessary

Glaucoma Testing

• Covered annually for those at high risk, including people with diabetes or a family history

Abdominal Aortic Aneurysm Screening

• One-time screening for people at risk, including men aged 65–75 who have smoked

How to Stay On Track with Preventive Care

It can be overwhelming to remember what you’re eligible for and when. Here’s how to stay organized:

• Use Medicare’s Preventive Services Checklist: Updated annually

• Schedule Your Annual Wellness Visit in Advance: This ensures timely planning for the year

• Ask About Risk-Based Eligibility: Especially if you have a family history of serious conditions

• Talk to Your Doctor About the Right Timeline: Some tests may be needed more often depending on your health status

What’s Not Considered Preventive?

Preventive services are meant to detect problems early, not manage existing ones. If a screening leads to a diagnostic test, or you receive treatment for a discovered condition, that part may involve additional costs.

Examples of Non-Preventive Services:

• Follow-up diagnostic colonoscopies

• Imaging tests to investigate abnormalities

• Treatments or specialist visits following a positive screening result

These services often fall under Medicare Part B or Part A, depending on whether they are inpatient or outpatient. Deductibles and coinsurance may apply.

Avoid Surprises by Knowing the Rules

To get the most from your preventive benefits:

• Always Use Medicare-Participating Providers: This ensures full coverage without unexpected bills

• Check Coverage Frequency: Some services are limited to once a year or less

• Review Your Medicare Summary Notice (MSN): This document outlines what Medicare paid and what you may owe

Taking Control of Your Preventive Health in 2025

You have more control than ever over your health outcomes when you take advantage of what Medicare offers for preventive care. The key is to stay informed, be proactive, and prioritize regular wellness visits and screenings.

Talk to a licensed agent listed on this website for professional guidance tailored to your specific Medicare plan.