What Medicare Covers for Preventive Care — and How It Actually Works

One of the most common things new Medicare enrollees discover is that preventive care works differently here than it did under their employer plan. The coverage is real and often more comprehensive than people expect, but the structure is different — and knowing that difference can save you from a surprise bill.

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The Two Visits That Confuse Almost Everyone

Medicare offers two distinct preventive visits, and many people don't realize they're separate — or that they have different eligibility windows.

 

The Welcome to Medicare Visit is a one-time visit available within your first 12 months of Part B enrollment. It's a chance to review your health history, establish a baseline with your doctor, and get a referral for any screenings you may need. This visit is covered at no cost to you when you see a participating provider.

 

The Annual Wellness Visit is available every year after your first 12 months of Part B. It's not a physical exam in the traditional sense — your doctor won't check your blood pressure, listen to your heart, or address a specific health concern during this visit without potentially triggering additional charges. What it does include is a health risk assessment, a review of your current medications, and a personalized prevention plan. Understanding this distinction before you schedule the appointment can help you plan accordingly.

Cancer Screenings Medicare Covers

Medicare covers a broad range of cancer screenings, most of them at no cost when you use a participating provider and meet the eligibility criteria for your age and risk profile.

 

  • Mammograms: one baseline mammogram between ages 35 and 39, then one screening mammogram every 12 months for women 40 and older
  • Colorectal cancer screenings: colonoscopies, fecal occult blood tests, and sigmoidoscopies, with frequency depending on your personal and family health history
  • Cervical and vaginal cancer screenings: Pap tests and pelvic exams covered once every 24 months, or once every 12 months if you're at high risk
  • Prostate cancer screenings: a PSA blood test and digital rectal exam covered once every 12 months for men 50 and older

 

Eligibility windows and covered frequencies can shift based on individual risk factors. When in doubt, ask your doctor to confirm coverage before scheduling.

Cardiovascular, Diabetes, and Bone Health Screenings

Beyond cancer, Medicare covers several screenings that address the health conditions most common among people 65 and older.

 

Cardiovascular screening covers blood tests for cholesterol, lipid levels, and triglycerides once every five years. Diabetes screening covers up to two fasting glucose tests per year for people at risk, based on factors like high blood pressure, obesity, or a family history of diabetes. If you've already been diagnosed with diabetes, Medicare covers additional monitoring and self-management training as well.

 

Bone density screening is covered once every 24 months for people at risk of osteoporosis — including women who are postmenopausal and individuals on certain long-term medications. Your doctor can order this screening and confirm whether your situation qualifies.

Vaccines and Mental Health Screenings Covered Under Medicare

Medicare Part B covers several vaccines as a preventive benefit, typically at no cost when administered by a participating provider.

 

  • Flu vaccine: once per flu season
  • Pneumococcal vaccines: two different vaccines are covered, typically given at separate intervals
  • COVID-19 vaccines: covered with no cost-sharing
  • Hepatitis B vaccine: covered for people at medium to high risk

 

Medicare also covers an annual depression screening, which takes place in a primary care setting and is covered at no cost. Alcohol misuse screening and brief counseling are covered as well. These screenings are easy to overlook, but they're built into the preventive benefit for a reason — and they cost you nothing to use.

A Resource Worth Bookmarking

The Centers for Medicare and Medicaid Services publishes a Medicare Preventive Services Quick Reference Chart that lists every covered preventive service, the eligibility criteria, and how often each is covered. It's the same resource referenced in consultations here, and it's worth having on hand when you're scheduling care or reviewing what's available to you.

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Common Questions About Medicare Preventive Services

  • Does Medicare cover an annual physical?

    Medicare doesn't cover a traditional annual physical the way most employer plans do. Instead, it covers the Annual Wellness Visit, which focuses on health risk assessment, medication review, and preventive planning rather than a head-to-toe physical exam. If your doctor addresses a specific medical concern during that visit, it may be billed separately and subject to your Part B deductible and coinsurance.

  • What preventive services does Medicare cover for free?

    Most Medicare-covered preventive services — including the Welcome to Medicare Visit, the Annual Wellness Visit, covered cancer screenings, cardiovascular and diabetes screenings, and recommended vaccines — are available at no cost to you when you see a participating provider and meet the eligibility criteria. Cost-sharing can apply if additional services are provided during the same visit.

  • What is the Welcome to Medicare visit and when can I use it?

    The Welcome to Medicare Visit is a one-time preventive visit available within the first 12 months after your Part B coverage begins. It's designed to review your health history, establish a baseline, and identify any screenings or referrals you may need. If you miss the 12-month window, you lose access to this particular visit — it does not carry over.

  • How is the Annual Wellness Visit different from a regular doctor's appointment?

    The Annual Wellness Visit is a structured preventive benefit, not a sick visit or a general checkup. It includes a health risk assessment, a review of your current medications and functional ability, and a personalized prevention plan. It does not include a physical exam. If you come in with a specific concern that your doctor needs to evaluate, that portion of the visit may be billed separately under Part B.

  • Do Medicare Supplement plans affect my preventive care coverage?

    Medicare Supplement plans — also called Medigap plans — generally cover the cost-sharing that Medicare Part B leaves behind, such as your 20% coinsurance after the deductible. For preventive services that Medicare covers at 100%, a Supplement plan typically has no additional role. Where a Supplement plan helps most is when a preventive visit leads to additional services that do carry cost-sharing. You can learn more about how Supplement plans work on the Medicare Supplement Plans page.
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Questions About Your Coverage? Let's Talk Through It.

Medicare's preventive benefits are genuinely useful — but the rules around eligibility, visit types, and billing can be hard to navigate on your own. If you're not sure what your current plan covers, or you're approaching Medicare for the first time and want to understand what to expect, a conversation can clear things up quickly. There's no cost for a consultation, and no pressure to make any changes.