Medicare Preventative Health Benefits

Preventive Service | How Often Allowed | Additional Details |
Abdominal Aortic Aneurysm Screening Ultrasound |
Once with certain risk factors and referral from practitioner |
Covered at 100% |
Alcohol Misuse Screening and Counseling |
Screening: Once per year Counseling: 4 times per year for those who screen positive |
Covered at 100% |
Annual Wellness Visit (Not a full physical, prevention planning only) |
Annually 12 months after Part B effective date |
Covered at 100% |
Bone Mass Measurement |
Every 2 years if at risk; More frequently if high risk |
Covered at 100% |
Cardiovascular Disease Screening |
Once every 5 years for all beneficiaries with no signs or symptoms |
Covered at 100% |
Cardiovascular Disease Behavioral Therapy |
One CVD risk reduction visit annually |
Covered at 100% |
Colorectal Cancer Screening: Screening Colonoscopy |
Normal risk: Once every 10 years High risk: Once every 2 years |
Covered at 100% |
Colorectal Cancer Screening: Fecal Occult Blood Test |
Every year |
Covered at 100% |
Colorectal Cancer Screening: Flex Sigmoidoscopy |
Once every 4 years unless screening colonoscopy was performed less than 120 months prior |
Covered at 100% |
Colorectal Cancer Screening: Barium Enema |
Once every 4 years if used instead of Flex sigmoidoscopy |
You pay 20% of the Medicare-approved amount; deductible waived |
Colorectal Cancer Screening: sDNA Test |
Once every 3 years |
Covered at 100% |
Depression Screening |
Once per year |
Covered at 100% |
Diabetes Screening |
One screening per year if not diagnosed pre-diabetic; Twice per year if diagnosed pre-diabetic |
Covered at 100% |
Diabetes Self-Management Training |
Initial training: Up to 10 hours within a 12 month period Subsequent years: Up to 2 hours within a 12 month period |
You pay 20% of the Medicare-approved amount after meeting the Part B deductible |
Flu Vaccine |
Once per influenza season |
Covered at 100% |
Glaucoma Screening |
Once per year for those at risk |
You pay 20% of the Medicare-approved amount after meeting the Part B deductible |
Hepatitis B Vaccine |
Three scheduled injections for those at medium or high risk |
Covered at 100% |
Hepatitis C Screening |
Annually for those at high risk; or Once in a lifetime for those born between 1945 and 1965 |
Covered at 100% |
HIV Screening |
Once per year for those at risk; Three times per pregnancy for those who are pregnant |
Covered at 100% |
Initial Preventive Physical Exam (IPPE) "Welcome to Medicare Exam" |
Once for all new beneficiaries within 12 months of starting Part B |
Covered at 100% |
Lung Cancer Screening |
Low-dose CT once per year for those who are high risk |
Covered at 100% |
Mammogram |
Once for those aged 35-39; Annually for those 40 and older |
Covered at 100% |
Medical Nutrition Therapy |
First year: 3 hours of counseling; Subsequent years: 2 hours *For those diagnosed with diabetes, renal disease, or have had a kidney transplant |
Covered at 100% |
Obesity Behavior Therapy |
For those with a BMI >30 First Month: one visit every week; Months 2-6: one visit every other week; Months 7-12: one visit every month |
Covered at 100% |
Pap Test and Pelvic Exam |
Annually for those at high risk; Every 2 years for normal risk |
Covered at 100% |
Pneumonia Vaccine |
An initial vaccine and a second vaccine one year after the first was received |
Covered at 100% |
Prostate Cancer Screening |
Annually for males 50+ |
PSA Covered at 100%; DRE - You pay 20% of Medicare approved amount after meeting the Part B deductible |
Sexually Transmitted Infection Screening and Counseling |
Annually for those at high risk; More frequently if pregnant |
Covered at 100% |
Tobacco Use Cessation Counseling |
Two attempts per year (each attempt includes up to four counseling sessions) |
Covered at 100% |