Preventive care service
When it is covered for people with Medicare
Abdominal aortic aneurysm screening (screening for a weak area or bulge in the aorta, the body's main artery)
Once in your lifetime if you get a referral from your doctor.
Alcohol misuse screening and counseling
One screening per year if you use alcohol but don't meet the medical criteria for alcohol dependency. Also, up to four counseling sessions per year from a qualified primary care doctor in a primary care setting.
Bone mass measurements
Once every 24 months (more often if medically necessary) if you are at risk for osteoporosis (bone weakening) and have one of these medical conditions:
Breast cancer screening
Once every 12 months if you are a woman age 40 and older. Women 35–39 are covered for one baseline mammogram.
Cardiovascular behavioral therapy and screenings
Once each year. However, screening tests for cholesterol, lipid and triglyceride levels are covered once every 5 years.
Cervical and vaginal cancer screening
Once every 24 months for all women, or once every 12 months if you are a woman at high risk.
Colorectal cancer screening
There's no minimum age for having a screening colonoscopy. If you are 50 and or older, these screenings are covered at these times:
Once per year. Must be done in a primary care setting.
Diabetes screening and management training
Up to two diabetes screenings per year (based on the results of your first screening test) if you are at risk for diabetes.
Diabetes self-management training
If you have diabetes, you are covered for educational training to help manage it and prevent complications. You must have a written order from a doctor or other health care provider.
Once every 12 months if your doctor says you are at high risk for glaucoma.
Note: If you have a Medicare Supplement (Medigap) plan, you may pay 20% of the Medicare-approved amount after the yearly Part B deductible.
Hepatitis C screening test
A one-time hepatitis C screening test if one of these things are true:
Certain people at high risk are covered for repeat screening each year. A primary care doctor or practitioner must order the screening tests.
Once every 12 months if you are at increased risk (or if you ask for the test), or up to three times during a pregnancy.
Lung cancer screening
Once every 12 months with low dose computed tomography (LDCT) if you meet all of these conditions:
Before your first lung cancer screening, you need to schedule an appointment with your doctor to discuss the benefits and risks of lung cancer screening. You and your doctor can decide if lung cancer screening is right for you.
Nutrition therapy, medical
Three hours of one-on-one counseling the first year, and two hours each year after that if you have diabetes, kidney disease (but are not on dialysis) or after a kidney transplant. Your doctor must refer you for this service. If your condition, treatment or diagnosis changes, you may be able to get more hours of treatment with a doctor's referral.
Obesity screening and counseling
Anyone is covered for obesity screening. If you have a body mass index (BMI) of 30 or more, you are covered for intensive obesity counseling conducted in a primary care setting:
Preventive visit, "Welcome to Medicare"
Once in your lifetime within the first 12 months that you have Medicare Part B (medical insurance).
Preventive visit, yearly wellness
Once every 12 months after you have had Part B for longer than 12 months.
Note: You cannot have your first yearly wellness visit within 12 months of enrolling in Part B or having your "Welcome to Medicare" preventive visit. However, you don't need to have had a "Welcome to Medicare" preventive visit to in order to have a yearly wellness visit.
Prostate cancer screening
All men over 50.
Sexually transmitted infection screening and counseling
Screenings for chlamydia, gonorrhea, syphilis and hepatitis B once every 12 months or at certain times during pregnancy. Also, up to two individual 20–30 minute, face-to-face behavioral counseling sessions each year for sexually active adults at increased risk for sexually transmitted diseases. Your primary care doctor or other primary care practitioner must order the screening tests and provide the counseling.
Tobacco use cessation counseling
Up to eight face-to-face visits during a 12-month period if you use tobacco. A qualified primary care provider must give you these visits in a primary care setting.
Flu: Once a year per flu season. If you are 65 and older or if you are under 65 and have a chronic illness, including heart disease, lung disease, diabetes or end-stage renal disease (ESRD, or permanent kidney failure requiring dialysis or a kidney transplant), we strongly urge you to get a flu shot each year.
Last updated 10/01/2020