These preventive checkups help you maintain control of your health care
People who have had Medicare Part B for longer than 12 months are eligible for a free wellness exam.
The phrase “there is no free lunch” certainly applies to Medicare. While the federal program pays the lion’s share of medical costs, beneficiaries can still spend thousands of dollars each year on premiums, deductibles, copays and other out-of-pocket expenses.
But the Affordable Care Act (ACA) expanded access to free preventive care, and that included some important Medicare services. Here’s a list of some examinations and screenings Medicare recipients now get for free.
- A “Welcome to Medicare” preventive visit. This is available only in the first 12 months you are on Part B. It includes a review of your medical history, certain screenings and shots, measurements of vital signs, a simple vision test, review of potential risk for depression, an offer to discuss advance directives and a written plan outlining which screenings, shots and other preventive services you need. This visit is covered one time.
- Annual wellness visit. You’re eligible for this free exam if you’ve had Medicare Part B for longer than 12 months. The physician will review your medical history; update your list of providers and medications; measure your height, weight, blood pressure and other vital signs; and provide you with personalized health advice and treatment options.
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Note: While this visit is free, the doctor may order other tests or procedures for which you might have a deductible or copay.
- Mammogram. An annual screening mammogram is free. If you require a diagnostic mammogram, you’ll pay a 20 percent copay and the Part B deductible will apply.
- Colonoscopy. A screening colonoscopy once every 24 months is free if you're at high risk for colorectal cancer. If you aren't at high risk, Medicare covers this test once every 10 years.
- Diabetes screening. You’re eligible for two free screenings each year if you have a history of high blood pressure, abnormal cholesterol levels, are obese or have a history of high blood sugar levels. The screenings will also be free if two or more of these issues apply to you: You are over 65, are overweight or have a family history of diabetes, or you had diabetes when you were pregnant.
- Prostate cancer screening. An annual PSA test is free. A digital rectal exam will cost you 20 percent of the Medicare-approved amount plus the doctor’s services related to the exam. The Part B deductible also applies.
- Vaccines. Annual flu shots, vaccines to prevent pneumococcal infections such as pneumonia, and shots for hepatitis B (for those at high or medium risk) are covered free of charge.
Note: The shingles vaccine is not covered by Part A or Part B, but it may be covered by your Medicare Advantage (MA) plan or your Part D prescription drug plan.
- Cardiovascular disease (behavioral therapy). As a Medicare recipient, you also get a free yearly visit with your primary care provider to help you lower your risk for cardiovascular disease.
- Lung cancer screening. An annual test with low-dose computed tomography (LDCT) is free if you are between 55 and 77, don’t have any signs of lung cancer, are a smoker or have quit in the past 15 years, and you have a tobacco smoking history of at least 30 “pack years” (meaning you smoked an average of one pack a day for 30 years).
- Depression screening. A yearly screening is free if conducted in a primary care center where follow-up and referrals are available. Copays may apply for follow-up care.