Preventive care includes health services that help you stay well, lower your risk of disease, and detect health problems early, often when they’re easier to successfully treat. It can also help you manage existing chronic conditions and reduce your chances of complications.

Medicare preventive services can range from wellness visits, vaccines, and screenings to laboratory tests, health monitoring, and counseling. These services can also support healthy habits like staying active, eating well, maintaining a healthy weight, and avoiding smoking.

Does Medicare cover preventive care services?

Yes. Medicare covers many preventive care services in order to promote the health and well-being of its beneficiaries. Most of these services have been recommended by the U.S. Preventive Services Task Force and have no cost sharing because of the Affordable Care Act.

“Many older adults simply don’t realize the scope of benefits available to them,” said Ryan Ramsey, Associate Director of Health Care and Benefits at NCOA. “It’s smart to take full advantage of the screenings, vaccines, and Wellness Visits Medicare offers. It can help you catch health problems sooner and have more informed conversations with your doctor about staying healthy and independent.”

Can I get preventive care services if I have a Medicare Advantage plan?

Yes. Preventive care services are covered under Medicare, regardless of whether you have original Medicare or a Medicare Advantage plan. As long as you meet basic eligibility standards, you have the right to receive these services.

What is the difference between preventive services and diagnostic services?

A service is considered preventive if you have no prior symptoms of the disease. In some cases, Medicare only covers preventive care services if you have certain risk factors. On the other hand, diagnostic services tend to address symptoms or conditions that you already have. The classification of services as preventive versus diagnosis is important because it affects what you owe for them. You typically need to pay a copay, coinsurance, and/or deductible for diagnostic services.

Are preventive services free?

Yes. If you have original Medicare, you usually have no coinsurance or deductible for certain Medicare preventive care services if you see a health care provider who accepts Medicare assignment. Doctors who accept assignment cannot charge you more than the Medicare-approved amount for services.

If you have a Medicare Advantage plan, your plan cannot charge you for preventive care services that are free for people with original Medicare as long as you see in-network providers. If you see providers that are not in your plan’s network, charges typically apply.

Why was I charged for a preventive service?

Many preventive services are provided alongside care that is diagnostic or alongside other health care services. For example, the Annual Wellness Visit is a preventive screening and no cost sharing applies. But if your doctor or nurse investigates or treats a health issue during the Annual Wellness Visit, this additional care is not a part of the Annual Wellness Visit. Charges for additional health services typically apply for services related or unrelated to the preventive care. You also may be charged for a doctor’s visit if you meet with a physician before or after the service. Speak with your provider before receiving a preventive care service to understand the service and potential costs.

Does Medicare cover an annual physical as a preventive care service?

No. Rather than covering an annual physical, Medicare covers an initial "Welcome to Medicare" visit, and subsequent Annual Wellness Visits to promote preventive care. These are not head-to-toe physical exams. You can still receive an annual physical from your primary care provider under Medicare, but charges typically apply to this service.

What does the Welcome to Medicare visit include?

The Welcome to Medicare visit is a one-time preventive appointment available during your first 12 months enrolled in Medicare Part B. Your doctor or nurse will:

• Go over your medical and family history, medications, and risk factors.
• Take basic measurements like your height, weight, and blood pressure.
• Check your vision.
• Create a personalized plan for future screenings, vaccines, and other preventive care. 

Does Medicare cover cancer screenings?

Yes. Medicare Part B covers several cancer screenings, including those for breast, cervical, colorectal, lung, and prostate cancer. How often a screening is covered (and whether you’ll pay anything) depends on the type of test, your age, and your risk factors.

How often does Medicare cover preventive screenings?

It depends on the service. Some preventive screenings are covered every year, while others are available every few years or only once if you meet certain requirements. Your age, medical history, and risk factors may also affect how often you qualify. Ask your doctor or check Medicare’s preventive services list for the schedule that applies to you.

Do I have to see a specific provider for preventive care services?

Yes. Generally speaking, in order for services to be covered by Medicare, you must see a provider that accepts Medicare. If you have original Medicare, this means you must see a Medicare participating provider, which is a provider who accepts Medicare assignment and participates in the Medicare program. If you have a Medicare Advantage plan, you must see a provider that is in your plan’s network, which is a provider who accepts your Medicare Advantage plan as insurance. If you don't see a Medicare-participating provider or an in-network provider, cost sharing typically applies to your preventive care service.

Know that in order for some preventive care services to be covered, Medicare requires that you receive them from a certain kind of provider, such as a primary care provider.

This FAQ by the Medicare Rights Center describes the preventive care services covered by Medicare. It also notes if Medicare requires that you to receive the service from a certain kind of provider.