Does Medicare Cover Preventive Care?

One of the most common questions newcomers to Medicare ask is if Medicare covers preventive care. In the past (pre-2011), Medicare did not cover many of the preventive services that most people wanted or needed to pursue. However, starting 1/1/11, Medicare began to cover the majority of these preventive services, in accordance with recommendations by the U.S. Preventive Services Task Force.

Below, we’ve listed a comprehensive list of what preventive care services Medicare now covers. These services are required to be covered, regardless of whether you have “original” Medicare (Parts A & B) or coverage through a private Medicare plan, such as Medicare Advantage:

  • Diabetes screening – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Diabetes services and supplies – 80% of the Medicare-approved amount (after the Part B deductible) from different providers or the source site.
  • Medical nutritional therapy – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Alcohol misuse screening and counseling – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Depression screenings – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Sexually transmitted infection screening and counseling – 100% of the Medicare-approved amount (Part B deductible does not apply) for those at risk
  • HIV screenings – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Smoking cessation – 100% of the Medicare-approved amount (Part B deductible does not apply) for those who do not have a smoking-related illness (80% for those that do)
  • Glaucoma screening – 80% of the Medicare-approved amount (after Part B deductible)
  • Blood tests for heart disease – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Bone Mass measurement – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Cardiovascular risk reduction visits – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Obesity screening and counseling – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Screening mammograms – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Pap smears, pelvic exams and clinical breast exams – covers 100% for pap lab tests, pap test collections, clinical breast exams, and pelvic exams (Part B deductible does not apply)
  • Colon cancer screening – 80% for barium enema (no Part B deductible) and 100% for fecal occult blood test, flexible sigmoidoscopy, and colonoscopy (no Part B deductible)
  • Prostate cancer screening – 100% for PSA test (Part B deductible does not apply) and 80% of the Medicare-approved amount for digital rectal exam (after Part B deductible)
  • Flu shot – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Pneumonia vaccine – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Hepatitis B vaccine – 100% of the Medicare-approved amount (Part B deductible does not apply) for people at medium or hgh risk – covered by Part D (Rx coverage) for people at low risk
  • Annual wellness visit – 100% of the Medicare-approved amount (Part B deductible does not apply)
  • Abdominal Aortic Aneurysm Screening – 100% of the Medicare-approved amount for people at an increased risk of AAA who receive a referral during their Welcome to Medicare physical (see next bullet point)
  • Welcome to Medicare preventive visit – 100% of the Medicare-approved amount (Part B deductible does not apply)

Keep in mind that doctors who accept Medicare “assignment” cannot charge you more than the Medicare-approved amount. However, if your doctor doesn’t accept assignment or orders more tests/procedures, you will  be charged for those. If you have a Medicare supplement plan, depending on which plan you have, you may have $0 or a very minimal out of pocket costs for those additional tests.

Be sure to follow the Medicare guidelines for how often you can get these various preventive tests and procedures. These guidelines can be found on Medicare.gov or in the “Medicare and You” handbook. Also, you can access Medicare’s guidebook – “Your Guide to Medicare’s Preventive Services” – for more information. If you have any other questions or if we can help in any way, please call us at 877.506.3378 or visit our website at Medicare-Supplement.US

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  1. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

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  3. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

  4. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

  5. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

  6. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

  7. […] Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.Source: medicare-supplement.us […]

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