Manage Your Health
Health care to prevent illness or detect it at an early stage, when treatment is most likely to work best (for example, Pap tests, flu shots, and colorectal cancer screenings).
Use the Preventive Services Checklist below to talk to your doctor or other health care provider about Medicare’s preventive services and ask which services you need.
If you’re in a Medicare Advantage Plan, your costs may be different. Look at your plan’s Evidence of Coverage or contact your plan to find out about plan benefits and costs for preventive services.
Welcome to Medicare Preventive Visit
A one-time review of your health, and education and counseling about preventive services, including certain screenings, shots, and referrals for other care if needed. Medicare will cover this visit if you get it within the first 12 months you have Part B. You pay 20% of the Medicare-approved amount. When you make your appointment, let your doctor’s office know that you would like to schedule your “Welcome to Medicare” preventive visit.
Helps prevent influenza or flu virus. Covered once a flu season in the fall or winter. You need a flu shot for the current virus each year. No cost to you for the flu shot if the doctor accepts assignment for giving the shot.
Print off a copy of this checklist to discuss with your doctor or health care provider which services are right for you. And, use this checklist to help keep track of your preventive services.
Medicare’s free, secure online service for accessing personalized information regarding your Medicare benefits and services.
Managing Your Health Information Online
A personal health record (PHR) is a confidential and easy-to-use tool for managing information about your health. A PHR is usually an electronic file or record of your health information and recent services, such as your medical conditions, allergies, medications, and doctor or hospital visits that can be stored in one place, and then shared with others, as you see fit.
This tool allows you access to your prescription drug list to create, view or change your prescription drug and pharmacy information. You must first obtain a Drug List ID and Password Date through this tool in order to view your prescription drug cost information.
Preventive Services
Abdominal Aortic Aneurysm Screenings
A one-time screening ultrasound for people at risk.
Medicare covers one alcohol misuse screening per year. Counseling may be covered if your screening result is positive.
Helps to see if you are at risk for broken bones. This service is covered once every 24 months (more often if medically necessary) for people who have certain medical conditions or meet certain criteria.
Helps detect conditions that may lead to a heart attack or stroke. This service is covered every 5 years to test your cholesterol, lipid, and triglyceride levels.
Colon Cancer Screenings (Colorectal)
Medicare covers colorectal screening tests to help find pre-cancerous polyps (growths in the colon) so they can be removed before they turn into cancer.
Medicare covers depression screenings by your primary care doctor once every 12 months.
Diabetes screenings are covered if you have any of the following risk factors: high blood pressure (hypertension), history of abnormal cholesterol and triglyceride levels (dyslipidemia), obesity, or a history of high blood sugar (glucose). Based on the results of these tests, you may be eligible for up to two diabetes screenings every year.
Diabetes Self-Management Training
Your doctor or other health care provider must provide a written order.
EKG Screenings
Medicare covers a one-time screening EKG if you get a referral for it as a result of your one-time “Welcome to Medicare” Preventive Visit.
Covered once a flu season in the fall or winter.
Covered once every 12 months for people at high risk for glaucoma.
This is covered for people at high or medium risk for Hepatitis B. Your risk for Hepatitis B increases if you have hemophilia,End-Stage Renal Disease (ESRD), or a condition that increases your risk for infection. Other factors may increase your risk for Hepatitis B, so check with your doctor. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Medicare covers HIV screening for people with Medicare who are pregnant and people at increased risk for the infection, including anyone who asks for the test.
Medicare covers screening mammograms once every 12 months for all women with Medicare age 40 and older. Medicare covers one baseline mammogram for women between ages 35–39.
Medical Nutrition Therapy Services
Medicare may cover medical nutrition therapy and certain related services if you have diabetes or kidney disease, or you have had a kidney transplant in the last 36 months, and your doctor refers you for the service.
Obesity Screening and Counseling
If you have a body mass index of 30 or more, Medicare covers intensive counseling to help you lose weight. This counseling may be covered if you get it in a primary care setting, where it can be coordinated with your comprehensive prevention plan. Talk to your primary care physician or practitioner to find out more.
Medicare covers these screening tests once every 24 months, or once every 12 months for women at high risk, and for women of child-bearing age who have had an exam that indicated cancer or other abnormalities in the past 3 years.
Medicare will cover two types of preventive visits—one when you’re new to Medicare and one each year after that.
Most people only need this preventive shot once in their lifetime.
Medicare covers a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 months for all men with Medicare over age 50.
Smoking Cessation (counseling to stop smoking)
Medicare covers smoking cessation counseling as a preventive service and you’ll pay nothing for the counseling sessions.