Original Medicare covers preventive services, such as screenings, tests, and vaccines, to keep you in good health. Medicare Advantage (Part C) plans offer the same care plus other potential benefits.
Medicare Part B, which covers medical costs like doctor visits and outpatient procedures, includes coverage for several preventive health screenings, tests, and vaccines. Medicare Advantage (Part C) plans, which are private insurance products, also offer preventive care. Many of these plans provide access to extra services.
What are preventive services?
Generally speaking, tests are considered preventive screenings if you do not have any symptoms of the health condition they’re screening for. If you receive testing as part of a diagnosis, it is not covered as a preventive service, and you may need to pay a coinsurance fee or copay.
Read on to learn which preventive services are covered under Medicare, how often you can access them, and what they may cost.
Most of the time, Medicare limits preventive screenings to a certain number of tests per year.
If you’re at a higher risk for certain health conditions, Medicare may cover additional screenings. If you’re pregnant, for example, Medicare may pay for additional hepatitis screenings at several points during your pregnancy.
Medicare sometimes offers you preventive care at no cost, but other tests, screenings, and vaccines may require a copay or coinsurance. Here’s an at-a-glance summary of Medicare’s preventive services.
| Preventive care | How often? | Medicare requirements | Cost to you |
|---|---|---|---|
| abdominal aortic aneurysm screening | once | referral from your medical professional | $0 |
| alcohol misuse screening | once every 12 months | you must be an adult who has not received a diagnosis of alcohol misuse disorder | $0 |
| alcohol misuse counseling | 4 sessions every 12 months | one of these must be true: you’re estrogen-deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you’re taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy | $0 |
| bone density screening | once every 24 months | one of these must be true: you’re estrogen-deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you’re taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy | $0 |
| cardiovascular disease | once every 5 years | screening includes tests for cholesterol, lipids, and triglycerides | $0 |
| cardiovascular behavior therapy | once every 12 months | therapy must take place in a primary care setting | $0 |
| cervical/vaginal cancer screening | once every 24 months | one of these must be true: you’re estrogen deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you’re taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy | $0 |
| colorectal cancer (CRC) screen: multi-target stool DNA | once every 3 years | 20% of the cost, plus any hospital copay | $0 |
| CRC blood-based biomarker screening tests | once every 3 years | you must be between 45 and 85, have no CRC symptoms, and have an average risk level | $0 |
| CRC screen: barium enema | once every 48 months | tests include HPV and breast cancer screenings; If you had a positive pap test or you’re at high risk, you have a screening once per year | 20% of cost, plus copay |
| CRC screen: colonoscopy | once every 24 months | you must be 45 or older; if you’re at high risk, you have a screening once every 24 months | 20% of the cost of polyp removal |
| CRC screen: fecal occult blood test | once every 12 months | you must be 45 or older and have a referral | $0 |
| CRC screen: sigmoidoscopy | once every 48 months | you must be at high risk; if you aren’t at high risk, you can be screened once every 120 months | if you have a biopsy, you may pay coinsurance or a copay |
| depression | once every 12 months | screening must happen in a primary care setting | $0 |
| diabetes screening | twice every 12 months | 20% of the cost, plus any hospital copay | $0 |
| diabetes self-management training | 10 hours initially | 20% of the cost, plus any hospital copay | 20% of the cost |
| glaucoma screening | once every 12 months | you must be 45 or older; if you aren’t at high risk, you can be screened once every 120 months | 20% of cost, plus any hospital copay |
| hepatitis B virus infection screening | once every 12 months | one must be true: you have diabetes; you have a family history of glaucoma; you’re Black and over age 50; you’re Hispanic and over age 65 | $0 |
| hepatitis C virus infection screening | once every 12 months | your doctor must order it, plus: you must be high risk, you must have had a blood transfusion before 1992, or you must have been born between 1945 and 1965 | $0 |
| HIV | once every 12 months | you must be 15 to 65 years old or at high risk | $0 |
| lung cancer screening | once every 12 months | you must be at high risk; if you’re pregnant, you can be screened three times during pregnancy | $0 |
| mammogram | once every 12 months | you must be 50 to 77 years old and have no symptoms, or you must be a smoker (or have a history of 20 “pack years”; your doctor must order this test | if your test is diagnostic, you pay 20% of the cost |
| nutrition therapy | 3 hours the first year, 2 hours each year after that | your doctor must write a referral, and you must have diabetes, renal disease, or have had a kidney transplant within the last 3 years | $0 |
| obesity screening | one initial screening, plus behavioral therapy sessions | you must have a body mass index of 30 or more; screening must happen in a primary care setting | $0 |
| prostate cancer screening | once every 12 months | screening includes a digital exam and a blood test | $0 for exam, 20% for blood test |
| sexually transmitted infection screening | once every 12 months | screening includes chlamydia, gonorrhea, syphilis, and hepatitis B; two 20- to 30-minute counseling sessions are included | $0 |
| flu shot | once each flu season | — | $0 |
| COVID-19 vaccines | 2023-2024 formula | — | $0 |
| hepatitis B shots | — | you must be at medium to high risk | $0 |
| pneumococcal shots | 2 shots | they must be at least 1 year apart | $0 |
| smoking cessation counseling | 8 visits every 12 months | — | $0 |
| wellness visit | once every 12 months | — | there may be coinsurance if your doctor runs extra tests |
| Welcome to Medicare examination | once within 12 months of enrolling in Medicare Part B | — | $0 |
Original Medicare does not cover certain preventive services, including:
- dental cleanings
- eye exams for prescription lenses
- shingles vaccines
- Tdap shots
- fitness membership programs
If you have a Medicare Advantage plan, you’ll receive the same preventive services covered by Original Medicare.
However, many Medicare Advantage plans cover extra preventive services if you receive them from an in-network provider, including:
- dental cleanings
- eye exams
- shingles vaccines
- fitness membership programs
Since each Advantage plan is different, check your summary of coverage to see what preventive services are included in your plan.
Most of these screenings and preventive services are covered by Medicare Part B at no cost to you if your healthcare professional accepts the Medicare-approved cost of these services. You’ll have to pay Medicare Part B premiums, deductibles, and any applicable copays or coinsurance costs.
If your healthcare professional decides to add on other diagnostic tests, you may be responsible for part of the cost.
If you’re not sure whether a test is covered, talk with your healthcare professional about the costs beforehand, so you don’t have any surprising expenses.
If you visit your doctor after your screening, you may be charged separately for that visit. If your screening takes place in a specialized facility, there may be fees associated with that facility.
Preventive screenings must be administered by Medicare-approved healthcare providers. Otherwise, you may have to pay additional costs.
Other limitations are described in the table above.
Original Medicare and Medicare Advantage plans offer preventive services to help you maintain good health and detect any health problems early, when treatment may be most effective.
Though a few tests require a copay or coinsurance, most screenings and vaccines are covered under Medicare Part B and won’t cost you anything.
Talk with your healthcare professional to schedule these preventive services. A good time for that discussion might be during your annual wellness visit.