Medicare Part B (Medical Insurance) covers:
Abdominal aortic aneurysm screening
Medicare covers an abdominal aortic screening ultrasound once if you’re at risk. You’re considered at risk if you have a family history of abdominal aortic aneurysms, or you’re a man 65-75 and have smoked at least 100 cigarettes in your lifetime. You pay nothing for the test as long as the provider accepts assignment.
Alcohol misuse screenings & counseling
Medicare covers an alcohol misuse screening once per year if you’re an adult (including pregnant women) who uses alcohol, but you don’t meet the medical criteria for alcohol dependency. If your primary care doctor or other primary care practitioner determines you’re misusing alcohol, you can get up to 4 brief face-to-face counseling sessions each year (if you’re competent and alert during counseling). You pay nothing for the test as long as the provider accepts assignment.
Bone mass measurements (bone density)
Medicare covers this test once every 24 months (or more often if medically necessary) if you meet one of more of these conditions:
You pay nothing for the test as long as the provider accepts assignment.
Cardiovascular disease screenings
Medicare covers cardiovascular screening blood tests once every 5 years. You pay nothing for the test as long as the provider accepts assignment.
Cardiovascular disease (behavioral therapy)
Medicare covers a cardiovascular behavioral therapy visit one time each year with your primary care doctor or other qualified provider in a primary care setting (like a doctor’s office). You pay nothing for the test as long as the provider accepts assignment.
Cervical & vaginal cancer screening
Medicare covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer. Medicare covers these screening tests once every 24 months. If you’re at high risk for cervical or vaginal cancer, or if you’re of child-bearing age and had an abnormal Pap test in the past 36 months, Medicare covers these screening tests once every 12 months. You pay nothing for the lab Pap test, the lab HPV with Pap test, the Pap test specimen collection, and the pelvic and breast exams if your doctor or other qualified health care provider accepts assignment.
Part B also covers Human Papillomavirus (HPV) tests (as part of a Pap test) once every 5 years if you’re age 30-65 without HPV symptoms.
Colorectal cancer screenings
Multi-target stool DNA tests:
Medicare covers this at-home multi-target stool DNA lab test once every 3 years if you meet all of these conditions:
You pay nothing for this test if your doctor or other qualified health care provider accepts assignment.
Screening barium enemas:
Medicare covers this test if you’re age 50 or older. When this test is used instead of a flexible sigmoidoscopy or colonoscopy, Medicare covers the test once every 48 months if you’re age 50 or older and once every 24 months if you’re at high risk for colorectal cancer. You pay 20% of the Medicare-approved amount for your doctor’s services. In a hospital outpatient setting, you also pay a copayment. The Part B deductible doesn’t apply.
Screening colonoscopies:
Medicare covers screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There’s no minimum age requirement.
You pay nothing for this test if your doctor or other qualified health care provider accepts assignment. However, if a polyp or other tissue is found and removed during the colonoscopy, you may pay 20% of the Medicare-approved amount of your doctor’s services and a copayment in a hospital setting. The Part B deductible doesn’t apply.
Screening fecal occult blood tests:
Medicare covers screening fecal occult blood tests once every 12 months if you’re 50 or older, if you get a referral from your doctor, physician assistant, nurse practitioner or clinical nurse specialist. You pay nothing for this test if your doctor or other qualified health care provider accepts assignment.
Screening flexible sigmoidoscopies:
Medicare covers screening flexible sigmoidoscopies once every 48 months for most people 50 or older. If you aren’t at high risk, Medicare covers this test 120 months after a previous screening colonoscopy. You pay nothing if your doctor or other qualified health care provider accepts assignment.
If a screening flexible sigmoidoscopy results in the biopsy or removal of a lesion or growth during the same visit, Medicare considers the procedure diagnostic and you may have to pay coinsurance and/or a copayment, but the Part B deductible doesn’t apply.
Depression screenings
Medicare covers one depression screening per year. You pay nothing for this screening if your doctor accepts assignment.
Diabetes screenings
Medicare covers glucose laboratory test screenings (with or without a carbohydrate challenge) if your doctor determines you’re at risk for developing diabetes. You may be eligible for up to 2 screenings each year. Part B covers these lab tests if you have any of these risk factors:
You pay nothing for these tests if your doctor or other qualified health care provider accepts assignment.
Medicare also covers these screenings if 2 or more of these apply to you:
You pay nothing for these tests if your doctor or other qualified health care provider accepts assignment.
Diabetes self-management training
Medicare covers outpatient diabetes self-management training (DSMT) if you’ve been diagnosed with diabetes.
Medicare may cover up to 10 hours of initial DSMT – 1 hour of individual training and 9 hours of group training. You may also qualify for up to 2 hours of follow-up training each year if it takes place in a calendar year after the year you got your initial training.
You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Flu shots
Medicare covers one flu shot per flu season. You pay nothing for a flu shot if your doctor or other qualified health care provider accepts assignment for giving the shot.
Glaucoma tests
Medicare covers glaucoma tests once every 12 months if you’re at high risk for the eye disease glaucoma. You’re at high risk if one or more of these applies to you:
You pay 20% of the Medicare-approved amount and the Part B deductible applies.
In a hospital outpatient setting , you also pay a copayment .
Hepatitis B shots
Medicare covers these shots if you’re at medium or high risk for Hepatitis B. Your risk for Hepatitis B increases if one of these applies:
Other factors may also increase your risk for Hepatitis B. Check with your doctor to see if you're at high or medium risk for Hepatitis B.
You pay nothing for the shot if your doctor or other qualified health care provider accepts assignment.
Hepatitis B Virus (HBV) infection screening
Medicare covers a Hepatitis B Virus (HBV) infection screening if your primary care provider orders it and you're at high risk or pregnant.
You pay nothing for the screening test if your doctor or other qualified health care provider accepts assignment.
Your primary care doctor must order the HBV infection screening.
Medicare covers these tests:
Hepatitis C screening test
Medicare covers a screening test if your primary care doctor or other qualified health care provider orders one and you meet one or more of these conditions:
You pay nothing for the screening test if your doctor or other qualified health care provider accepts assignment.
Medicare will only cover Hepatitis C screening tests if your primary care doctor or other primary care provider orders them.
HIV screening
Medicare covers an HIV (Human Immunodeficiency Virus) screening once per year if you meet one of these conditions:
If you’re pregnant, you can get the screening up to 3 times during your pregnancy.
You pay nothing for the test if your doctor or other qualified health care provider accepts assignment.
Lung cancer screening
Medicare covers lung cancer screenings with Low Dose Computed Tomography (LDCT) once each year if you meet all of these conditions:
You pay nothing for this service if your doctor accepts assignment.
Before your first lung cancer screening, you’ll need to schedule a lung cancer screening counseling and shared decision-making visit with your doctor to discuss the benefits and risks of lung cancer screening. You and your doctor can decide whether lung cancer screening is right for you.
Mammograms (screening)
Medicare covers:
Nutrition therapy services
Medicare may cover medical nutrition therapy (MNT) services and certain related services if you have diabetes or kidney disease, or you’ve had a kidney transplant in the last 36 months.
You pay nothing for these preventive services because the Part B deductible and coinsurance don’t apply.
Obesity screenings & counseling
Medicare covers obesity screenings and behavioral counseling if you have a body mass index (BMI) of 30 or more. Medicare covers this counseling if your primary care doctor or other qualified provider gives the counseling in a primary care setting (like a doctor's office), where they can coordinate your personalized prevention plan with your other care.
You pay nothing for this service if your primary care doctor or other qualified primary care practitioner accepts assignment.
One-time “Welcome to Medicare” preventive visit
Medicare covers a “Welcome to Medicare” preventive visit once within the first 12 months you have Part B.
You pay nothing for the “Welcome to Medicare” preventive visit if your doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply.
However, you may have to pay coinsurance, and the Part B deductible may apply if:
Pneumococcal shots
Medicare covers 2 different pneumococcal shots. Part B covers the first shot at any time and a different, second shot if it’s given at least one year after the first shot.
You pay nothing for pneumococcal shots if your doctor or other qualified health care provider accepts assignment for giving the shots.
Prostate cancer screenings
Medicare covers digital rectal exams and prostate specific antigen (PSA) blood tests once every 12 months for men over 50 (starting the day after your 50th birthday).
Sexually transmitted infections screening & counseling
Medicare covers sexually transmitted infection (STI) screenings for chlamydia, gonorrhea, syphilis, and/or Hepatitis B if you’re pregnant or at increased risk for an STI.
Medicare also covers up to 2 individual 20-30 minute, face-to-face, high-intensity behavioral counseling sessions if you’re a sexually active adolescent or adult at increased risk for STIs.
Medicare covers these tests once every 12 months or at certain times during pregnancy. Medicare covers behavioral counseling sessions once each year.
You pay nothing for STI screenings and counseling if your doctor accepts assignment.
Covid Shot
Medicare covers FDA-authorized COVID-19 vaccines. You pay nothing for the COVID-19 vaccine. You won’t pay a deductible or copayment, and your provider can’t charge you an administration fee to give you the shot.
Tobacco use cessation counseling
Medicare covers up to 8 visits of smoking and tobacco-use cessation counseling visits in a 12-month period smoking if you use tobacco.
You pay nothing for the counseling sessions if your doctor or other qualified health care provider accepts assignment.
Yearly “Wellness” visit
If you’ve had Medicare Part B (Medical Insurance) for longer than 12 months, you can get a yearly “Wellness” visit once every 12 months to develop or update a personalized prevention plan to help prevent disease and disability, based on your current health and risk factors. Your provider may also perform a cognitive impairment assessment.
You pay nothing for this visit if your doctor or other qualified health care provider accepts assignment.
The Part B deductible doesn’t apply.
However, you may have to pay coinsurance and the Part B deductible may apply if:
What is it?
The cognitive impairment assessment is performed to look for signs of Alzheimer's disease or dementia and check for depression and other mood disorders. Your provider may order other tests, if necessary, depending on your general health and medical history.
The personalized prevention plan is designed to help prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It can also include: