What Preventive Services Are Covered By Medicare?
November 25, 2024 | Marcia Pruitt
Staying on top of your health is easier when you know what’s covered by Medicare. From essential screenings to vaccinations, preventive services are an important part of maintaining your health. Keep reading to find out more about what preventive care services entail and what is covered by Medicare.
What Are Preventive Care Services?
Preventive services can include screenings, examinations, lab tests and vaccinations. In addition, there are some counseling and educational programs Medicare may cover to support (with limitations), including health monitoring, that are geared towards making positive health changes.
Why Utilize Covered Preventive Care?
A proactive approach to your health care and well-being can help you stay healthy and ensure early detection of potential health concerns.
Which Preventive Services Does Original Medicare Cover?
- Initial “Welcome to Medicare” preventive visit
- Yearly “Wellness” visit
- Alcohol misuse screenings & counseling
- Bone mass measurements
- Cardiovascular disease screenings
- Cancer screenings
- Counseling to prevent tobacco use & tobacco-caused disease
- Depression screenings
- Diabetes screenings
- Glaucoma screenings
- HIV screenings
- Mammograms (screening)
- Certain vaccines and shots
- COVID-19
- Flu shots
- Hepatitis B
- Pneumocococcal
- Shingles
For the most up-to-date and complete list of preventive services covered by Original Medicare (Parts A & B), please visit the official Medicare website by clicking here: Preventive & Screening Services
Find out more about what’s covered by Medicare:
How Much Will I Pay for Preventive Services?
You will typically have no cost-sharing responsibility (no deductible, copay or coinsurance) for most preventive services when you see a provider that accepts Medicare assignment.
Sometimes, you might have to pay for extra services during a preventive care visit, even if the preventive service itself is supposed to be fully covered. For instance, if your doctor finds and treats a new or existing issue during your preventive care visit, you will likely have to pay for those extra services. For example, if routine blood work reveals abnormal blood sugar levels, it could result in additional costs or copays from the diagnostic testing or diagnosis.
Related: Medicare Benefits You May Not Know About
Preventive Care Services with a Medicare Advantage Plan
If you are enrolled in a Part C Medicare Advantage Plan (MA/MAPD), you will not have to pay anything for preventive services covered by Original Medicare, as these plans are mandated to cover your care without charging deductibles, copayments, or coinsurance, provided you meet Medicare’s eligibility criteria for the service. Keep in mind that you may be charged more for seeing an out-of-network provider.
Medicare Advantage Plans may also offer coverage for preventive services that are not covered by Original Medicare. These services may have no patient responsibility or may be subject to a copay charge. Some typical preventive care services covered by many Medicare Advantage Plans but not by Original Medicare include annual physical exams, routine eye exams, and routine hearing exams.
When you stay informed about the preventive services covered by Medicare, you can benefit from a better understanding of covered care that can help you maintain your health. For the latest information on covered preventive services, visit the official Medicare website or set up a free, no-obligation consultation with one of our trusted Medicare brokers. Our experienced, licensed Medicare agents can help educate you on all the details of Original Medicare supplemental plan coverage.
Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Attend an online Medicare webinar, in-person Medicare workshop, or schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!
Do you need help with Medicare, insurance and health plans? Explore your options with Allina Health Aetna, BlueCross BlueShield of Minnesota, Medica, UCare, United HealthCare and more. We work with you to find the best plan for your needs and budget. Contact us today to get started.
