Understanding Medicare’s Preventive Services: Your Complete Guide

Medicare’s preventive services are all about keeping you healthy and catching potential health issues early. Many common health problems can be avoided or better managed if they’re found in the early stages. In this guide, we’ll explain what preventive services are, why they matter for older adults, and exactly what Medicare Part B covers – from screenings and vaccines to annual wellness visits. Best of all, we’ll highlight that these services are usually available at no cost when you’re eligible. We’ll also cover how to schedule preventive care and how a service like Breezly can help you stay on top of your appointments and wellness needs.

What Are Preventive Services and Why Do They Matter?

“Preventive services” include health care like exams, shots (vaccines), lab tests, and screenings that are done before you have obvious symptoms of an illness. The goal is to prevent diseases or detect them early when they’re easier to treat. According to Medicare.gov, preventive services help you stay healthy by finding problems early, determining the most effective treatments, and even preventing certain diseases from occurring. In other words, these services are proactive measures – things like blood pressure checks or cancer screenings – that can catch issues before they become serious. For older adults, preventive care is especially important because it can maintain quality of life and independence. It’s much better to prevent a health crisis than to treat one, and that’s exactly what these services aim to do.

Why it matters: As we age, the risk for chronic conditions (like heart disease, diabetes, or osteoporosis) increases. Preventive tests and screenings can find early warning signs of these conditions. For example, a simple bone density scan can detect osteoporosis early and help you start treatment to prevent fractures. Vaccinations can prevent dangerous infections like the flu and pneumonia. By using preventive services, you’re taking charge of your health and potentially adding healthy years to your life​.

Medicare Part B’s Preventive Benefits (What’s Covered)

Medicare Part B (Medical Insurance) covers a wide range of preventive services to help keep you healthy. In fact, Medicare Part B covers dozens of different screenings, counseling sessions, and vaccines under its preventive benefits​. These benefits are available to anyone with Part B who meets the eligibility criteria for each service (often based on age, gender, or risk factors). Here is an overview of the key preventive services Medicare covers:

Screenings

Medicare covers screenings for many common health conditions. This includes various cancer screenings – for example, screening mammograms (for breast cancer) every 12 months for women over 40, and colorectal cancer screenings such as colonoscopies at recommended intervals. It also covers screenings for cervical and vaginal cancer (like Pap tests and pelvic exams), prostate cancer (PSA tests for men over 50), and lung cancer (annual low-dose CT scans if you’re at high risk, such as a long-term smoker).

Beyond cancer, Part B covers checks for osteoporosis (bone mass measurements, usually for women 65+ or others at risk) and cardiovascular disease (blood pressure, cholesterol, and other cardiovascular screenings). You can also get screened for diabetes (blood glucose testing if you have risk factors or are 65+), and depression (an annual depression screening in a primary care setting)​. Other covered screenings include tests for glaucoma (for those at high risk), hepatitis B and C, HIV, and sexually transmitted infections (STIs) when applicable​. All these screening tests are designed to catch health issues early on.

Vaccines (Immunizations)

Part B covers a number of important vaccines for older adults. Flu shots are covered once per flu season (and are recommended yearly for everyone, especially seniors)​. The COVID-19 vaccine (and boosters) is covered as frequently as recommended – Medicare fully covers COVID-19 vaccination to protect you from serious illness​. Pneumococcal vaccines (to prevent pneumonia and related infections) are also covered – typically you’ll get the pneumococcal shots starting at age 65, per CDC guidelines​. In addition, Medicare Part B covers the Hepatitis B vaccine for those at medium or high risk (such as people with diabetes or kidney disease)​.

What about shingles? The shingles vaccine (Shingrix) is recommended for adults 50 and older to prevent painful shingles outbreaks​. Medicare covers the shingles vaccine under Part D (Medicare’s prescription drug coverage). Thanks to recent changes in law, as of 2023 Medicare beneficiaries pay no out-of-pocket cost for Shingrix when it’s covered by their Part D plan, making this important vaccine effectively free as well.

In short, Medicare ensures you can get crucial vaccines – flu, COVID-19, pneumonia, shingles, and more – with no copays, keeping you safe from preventable diseases.

Annual Wellness Visit and Other Preventive Visits

Medicare also covers dedicated preventive care visits. When you first enroll in Part B, you are eligible for a one-time “Welcome to Medicare” preventive visit during your first 12 months of coverage​. This initial visit is a comprehensive check-up that includes a review of your medical history, basic measurements (like height, weight, blood pressure), and guidance on preventive services you may need.

After that, Medicare covers an “Annual Wellness Visit” once every 12 months (after you’ve had Part B for at least a year)​. The Annual Wellness Visit is not a head-to-toe physical exam, but rather a yearly appointment to create or update a personalized prevention plan. During this visit, your doctor will typically assess your health risks, screen for cognitive issues (like memory problems), update a list of your providers and medications, and give you a checklist of preventive services you should get.

Both the Welcome to Medicare visit and the Annual Wellness Visit are fully covered by Medicare (no cost to you) if you see a participating provider. These visits are great opportunities to discuss which screenings or shots are due and to make a plan for your health.

Health Monitoring & Counseling

In addition to screenings and shots, Medicare covers various counseling services aimed at prevention. For example, Part B covers nutrition therapy services with a registered dietitian for people with diabetes or kidney disease​. It also covers obesity screening and counseling for beneficiaries with a body mass index (BMI) of 30 or higher​.

If you’re trying to quit smoking, Medicare covers counseling to prevent tobacco use (up to 8 sessions of cessation counseling)​. There’s also coverage for alcohol misuse counseling (if you screen positive for risky drinking, you can get counseling sessions), and even a structured Diabetes Prevention Program of healthy lifestyle coaching for those with pre-diabetes​. These services provide education and support to help you make healthy changes – all as part of your Medicare preventive benefits.

No-Cost Coverage – Medicare Preventive Services Are Free for You

One of the best things about Medicare’s preventive services is that they are provided with no out-of-pocket cost in most cases. Medicare Part B covers 100% of the approved amount for these preventive services, so you pay nothing (no copay and no deductible) as long as you meet the eligibility criteria and see a provider who accepts Medicare assignment.

“Accepting assignment” means the doctor or clinic agrees to Medicare’s payment – virtually all doctors who see Medicare patients do this for covered preventive services.

For example, Medicare covers a screening mammogram every year for women 40+ at no cost. The official Medicare policy states: “You pay nothing for the test if your doctor or other health care provider accepts assignment.” This is true for almost all Medicare-covered screening tests and vaccines – whether it’s a blood glucose test for diabetes, a colonoscopy for colon cancer, or a flu shot, you will not have to pay anything out-of-pocket if you are eligible and the provider is in Medicare’s network​.

The only time you might pay is if a service is diagnostic (for example, if something is found and you need follow-up tests, those might be billed differently) or if you exceed the frequency limits (like wanting a test more often than Medicare covers). But the bottom line is that Medicare’s preventive benefits are there for you free of charge. Cost shouldn’t be a barrier – in fact, the whole point is to encourage you to get these important services done.

(Do note that if you’re in a Medicare Advantage plan, these preventive services are also free; Medicare Advantage plans are required to cover all Part B preventive services without cost-sharing, as long as you follow plan rules on which providers you can use.)

How to Schedule and Use Preventive Services (Breezly Can Help!)

Using your Medicare preventive benefits is usually simple. For many screenings and the annual wellness visit, the first step is to contact your primary care provider to schedule an appointment​. Medicare.gov advises beneficiaries to talk with their doctor about what screenings or vaccines they need and to set up those services​.

You might schedule some services as part of your regular checkups – for example, during your Annual Wellness Visit, your doctor can order labs or refer you for screenings like a colonoscopy or mammogram. Other services, like the flu shot or COVID-19 vaccine, can often be obtained at a local pharmacy or clinic; just show your Medicare card and there should be no charge.

Here are some tips to make sure you get the most from Medicare’s preventive services:

• Review what you’re due for: Make a list of preventive services you might need based on your age and health. Medicare provides a handy Preventive Services Checklist that you can use to track which services you’ve had and when​.

• Talk to your doctor: At your next appointment, ask, “Doctor, what preventive tests or shots do I need?” They can tell you which screenings are recommended for you this year.

• Plan out the year’s appointments: It helps to map out roughly when and where you’ll do each preventive service.

• Use reminders: Breezly can act as your personal health assistant, reminding you about upcoming preventive services and helping you schedule appointments.

• Take advantage of community resources: Community health centers, pharmacies, and local health departments often host preventive care events – like “flu shot clinics” or free screening days.

Taking Charge of Your Preventive Care

Medicare’s preventive services are there to help you enjoy a healthier, happier life in your senior years. From cancer screenings and diabetes checks to vaccines and wellness visits, Part B offers a complete toolbox of preventive care at no cost to you​. Now that you understand what’s available, make sure you’re getting all the services you’re eligible for.

Spread the word to friends or family on Medicare too, because these benefits can improve and even save lives. And if keeping track of appointments feels overwhelming, remember that Breezly is ready to assist you in managing your healthcare. Staying healthy is a lot easier when you have the right information and support – and Medicare’s preventive services plus a helping hand from Breezly give you exactly that.