Preventive care

Preventive care and early detection are important for your health and well-being. That's why we cover a wide variety of preventive services with no copay and no deductible, meaning no out-of-pocket costs to you. Check the list below to see which preventive services are covered. This is the standard Original Medicare benefit and may not reflect your cost share responsibility. Refer to the Evidence of Coverage (EOC) for your plan benefits.

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:

  • You are a woman and your health care provider says you have a low estrogen level and are at risk for osteoporosis based on your medical history and other findings.
  • You have vertebral abnormalities (something is wrong with your spine) as shown by an X-ray.
  • You are getting steroid treatments.
  • You have hyperparathyroidism (an excess of a hormone that can weaken your bones due to calcium loss).
  • You are taking an osteoporosis drug.

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

If you are 50 and or older, these screenings are covered at these times:

  • Screening fecal occult blood test: Once every 12 months
  • Screening flexible sigmoidoscopy: Once every 48 months after the last flexible sigmoidoscopy or barium enema, or 120 months after a previous screening colonoscopy
  • Screening colonoscopy: Once every 120 months (every 24 months if you are at high risk) or 48 months after a previous flexible sigmoidoscopy
  • Screening barium enema: Once every 48 months (every 24 months if you are at high risk) when used instead of sigmoidoscopy or colonoscopy

Depression screening

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.

Glaucoma screening

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:

  • You are at high risk because you use illegal injectable drugs or you did in the past.
  • You are at high risk because you had a blood transfusion before 1992.
  • You were born between 1945 and 1965.

Certain people at high risk are covered for repeat screening each year. A primary care doctor or practitioner must order the screening tests.

HIV screening

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:

  • Are age 55–77.
  • Are not showing symptoms of lung cancer.
  • Are either a current smoker or have quit smoking within the last 15 years.
  • Have smoked an average of one pack a day for 30 years.
  • Get a written order from your doctor or a qualified provider.
  • You use an appropriate radiology imaging center and a reading radiologist that meets Medicare standards.

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:

  • One face-to-face visit each week for the first month
  • One face-to-face visit every other week for months 2–6
  • One face-to-face visit every month for months 7–12 if you lose 6.6 pounds during months 1–6

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.

  • Digital rectal examination: Once every 12 months
  • PSA test: Once every 12 months

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.

Pneumonia (pneumococcal infection): Usually once in your life, but there are exceptions. If you are 65 and older, we strongly urge you to get vaccinated.

Hepatitis B: Certain people at medium or high risk for hepatitis B are covered for hepatitis B shots. Check with your doctor about when to get hepatitis B shots if you qualify to get them. You will need three shots for complete protection against hepatitis B.

Note: Other vaccines may be covered under your Medicare Part D prescription drug plan. Deductibles, copays and coinsurance may apply. For more information, visit the Pharmacy page or call us at the number on the back of your member ID card.

Last updated 11/03/2021