Medicare Preventive Services

Under the Affordable Care Act, if you have Original Medicare, you may qualify for a yearly wellness visit and many preventive services for free.

Annual Wellness Visits: If you are new to Medicare, your “Welcome to Medicare” preventive visit is now covered without cost sharing during your first 12 months of Part B coverage. This exam is a one-time review of your health as well as education and counseling about preventive services and other care. If you’ve had Part B for longer than 12 months, you can get a yearly wellness visit to develop or update a personalized prevention plan based on your current health and risk factors. Video: Learn More About Annual Wellness Visits.

Several preventive services that qualify are listed below:

• Tobacco Use Cessation Counseling: This benefit is now considered a covered preventive service, whether or not you have been diagnosed with an illness caused or complicated by tobacco use.  While the counseling is a covered service, the co-insurance and deductible will apply if you have already been diagnosed with a tobacco related illness.
• Screenings: No more Medicare Part B deductible or copayment for these screenings if certain coverage criteria apply:
  • Bone mass measurement
  • Cervical cancer screening, including Pap smear tests and pelvic exams
  • Cholesterol and other cardiovascular screenings
  • Colorectal cancer screening (except for barium enemas)
  • Diabetes screening
  • Flu shot, pneumonia shot, and the hepatitis B shot
  • HIV screening for people at increased risk or who ask for the test
  • Mammograms
  • Medical nutrition therapy to help people manage diabetes or kidney disease
  • Prostate cancer screening (except digital rectal examinations)
  • See the full list of preventive services at Medicare.gov

Some Important Details

• For some preventive services, you will pay nothing. You may have to pay co-insurance (a part of the cost) for the office visit when you get these services.
• Your first yearly wellness visit can’t take place within 12 months of your “Welcome to Medicare” preventive visit.
• If you’re in a Medicare Advantage Plan, check with your plan to see if these benefits will also be free for you.

For More Information

• Helen's Story: Giving Seniors Peace of Mind and More Money in Their Pockets
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• Learn more about Medicare preventive services.
• Video Gallery: Medicare Preventive Benefits.
• HealthCare Blog: 22 Things You Need to Know.
• Fact Sheet: Seniors and the Affordable Care Act.
• Use our interactive FAQ tool to find answers to Medicare-related questions or ask your own at answers.healthcare.gov.

Posted on: December 27, 2010 
Last updated: May 4, 2012