I keep hearing about free preventive services with Medicare. What exactly is free and what will I still pay for?

Question

Steve Wilson · Accepted Answer

Medicare covers preventive services that per the Medicare.gov website are identified as exams, shots, lab tests, and screenings.  They key benefit that Medicare does not specifically cover are Routine Physical Exams.  The majority of Medicare Advantage plans do cover a routine annual exam and typically they are a $0 copay.  

It is really important when setting up a routine physical exam with your doctor or provider that you have a good understanding of what services will be provided.  For example, lets say your Medicare Advantage plan covers the routine physical exam which would include all of the $0 copay screenings, shots, and lab tests covered by Medicare. Those items would be a $0 copay.  I never use the word free and Medicare does not allow a broker to ever use the word free.

It is common though that a good provider will ask you if there are other things you would like to discuss during your visit.  Those items could be outside of the routine exam and you might have a copay for that portion of your visit.  Lets say for example that you wish to discuss shoulder or knee pain you have been having.  Those discussions are generally beyond your preventive $0 copay services and could trigger a copay for you.

In conclusion, its important to know that Medicare encourages all consumers to stay healthy and obtain the preventive services that have a $0 copay.  It would only be services beyond or outside of the routine physical exam, tests, labs, screening that you might see additional costs.

Gary Church · Answer

Nothing's free! Annual wellness and preventive services are included in your plan at no cost. To find out what is considered preventive or part of your wellness plan, review your plan documents, check with a licensed Medicare agent, or call Medicare.

Answered by Gary Church on October 1, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Steve and Sue Brauer · Answer

There should be no copay for preventative services with Medicare, or with any health plan for that matter. That was addressed with the beginning of the Affordable Care Act, or in slang terms ObamaCare.

Answered by Steve and Sue Brauer on April 8, 2025

Broker Licensed in AZ & CA

Answered by Steve and Sue Brauer Medicare Insurance Agent

Mike Alexander · Answer

There is a list of all preventative procedures covered on medicare.gov ,
You can also look at your plans outline to see what is covered.

Daniel Brechin · Answer

Yes, having an annual preventive appointment is free with most Medicare Advantage plans. By getting regular free checks the hope is to find out about problems at an early point as opposed finding the problem has advanced to more serious situations.

Answered by Daniel Brechin on October 4, 2025

Agent Licensed in AL, FL, KY, MS & TN

Answered by Daniel Brechin Medicare Insurance Agent

John Becker · Answer

Medicare Part B covers many preventive services at 100% with no deductible or copayment if you meet the eligibility criteria and the provider accepts Medicare assignment. However, some services may still have cost-sharing (20% coinsurance) depending on specific conditions or if a screening turns diagnostic. 
What is Free (No Cost)
The following preventive services are generally covered with no out-of-pocket costs when performed by a Medicare-approved provider: 
•	"Welcome to Medicare" preventive visit: A one-time visit within the first 12 months of enrolling in Part B.
•	Annual Wellness Visit (AWV): A yearly visit to develop or update a personalized prevention plan (not a physical exam).
•	Vaccinations: Flu shots, pneumococcal shots, COVID-19 vaccines, and Hepatitis B shots for intermediate/high-risk individuals.
•	Screenings:
o	Abdominal aortic aneurysm screening (one-time for qualifying individuals).
o	Alcohol misuse screening and counseling.
o	Bone mass measurements (for qualifying individuals).
o	Cardiovascular disease screenings (cholesterol, lipid, and triglyceride levels) once every 5 years.
o	Cervical and vaginal cancer screenings (Pap tests and pelvic exams).
o	Colorectal cancer screenings (fecal occult blood tests, flexible sigmoidoscopies, colonoscopies, etc., at set intervals).
o	Depression screenings.
o	Diabetes screenings (for those at risk).
o	Hepatitis C screening (for qualifying individuals).
o	HIV screening (for qualifying individuals).
o	Lung cancer screening (for qualifying individuals at high risk).
o	Mammograms (screening) once every 12 months.
o	Obesity screening and behavioral therapy.
o	Prostate cancer screening (digital rectal exam is free, but the associated blood test has a 20% coinsurance).
o	Sexually transmitted infections (STI) screenings and counseling.
•	Counseling & Therapy:
o	Cardiovascular disease behavioral therapy.
o	Counseling to prevent tobacco use.
o	Medical nutrition therapy services (for those with diabetes or kidney dise

Lauren Fodde · Answer

Under Original Medicare (Part B), these services are typically $0 cost to you as long as the provider accepts Medicare and the service is coded as preventative (not diagnostic). 

Common $0 Preventative Services:

Annual Wellness Visit
Flu Shot, Covid vaccines, etc. 
Mammograms
Colonoscopies 
Cardiovascular screenings
Diabetes screening
Depression screening
Bone density tests
Smoking cessation counseling

In simple terms:
Preventative = FREE (screenings, routine checks, vaccines)
Diagnostic or treatment = you may pay

When scheduling appointments, ask: Is this being billed as preventative or diagnostic? This one question can help you avoid unexpected bills.

Kate Spilsbury · Answer

Medicare covers a long list of preventive services at no cost, like your annual wellness visit, many vaccines, and routine screenings for things like cancer, diabetes, and heart disease. However, if your doctor finds something during a preventive visit and orders additional tests or treatments, those follow-up services may have a copay or coinsurance. It’s always smart to ask your provider upfront what’s fully covered and what might lead to extra costs.

Answered by Kate Spilsbury on October 20, 2025

Broker Licensed in FL, AZ, CA & 7 other states

Answered by Kate Spilsbury Medicare Insurance Agent

Joshua Allen · Answer

Medicare Part B covers many preventive services with no cost-sharing if you meet certain criteria and see a Medicare approved provider.  Free preventive services include:
-"Welcome to Medicare" Initial Preventive Visit
-"Wellness" Visit Annually
-Screening for many cancers, cardiovascular disease, diabetes, etc.
-Vaccinations such as Flu shots, COVID-19 vaccines, Hepatitis B shots, and Pneumococcal shots
-Counseling for alcohol misuse, tobacco use prevention/cessation, and obesity behavioral therapy
Services that you may still pay for:
-Diagnostic Services (If a preventive screening leads to the need for further testing or treatment, you may be responsible for a portion of the cost depending on your Medicare plan)
-Services from providers that do not participate with Medicare.
-Services not covered by Medicare.

Steven Bleicher · Answer

Depending on your chosen company and if you opted for a Supplement or an Advantage plan, there are 2 code #’s that a billing department person will code the treatment that was provided. If you made the appointment due to some pain you are feeling, then that is to be coded as “diagnostic” while a visit without pain is coded as “preventive”. Though, if during an annual checkup, the doctor discovers a “problem”, then the visit will change to a diagnostic code, even though it began as a preventive code. All doctor visits are covered by Medicare Part B at an 80% rate. The remainder of 20% is paid partially by the secondary insurance you have. If a new procedure has been done in a hospital, then Medicare Part A pays the 80% and the secondary again does the 20% in the same manner as above.

Answered by Steven Bleicher on April 10, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

Many Medicare preventive services are covered at no cost to you, with no deductible or coinsurance, if your provider accepts Medicare assignment.
     1) Annual Wellness Visit
     2) "Welcome to Medicare" Preventive Visit
     3) Various Screenings:
          * Bone Mass
          * Cardiovascular Disease
          * Cervical and Vaginal Cancer
          * Colon Cancer
          * Depression
          * Diabetes
          * Glaucoma
          * Hepatitis B & C
          * HIV
          * Lung Cancer
          * Mammograms
          * Obesity
          * Prostate Cancer
     4) Vaccines such as flu, pneumococcal, Hepatitis B, & COVID-19.
     5) Counseling

Kristen Skinner · Answer

If you have a Medicare plan or Medigap plan , you can go to the companies website and request the Summary of benefits for what is covered as preventive services. Or directly call them and request that to be sent to you.

Answered by Kristen Skinner on February 2, 2026

Broker Licensed in OK

Answered by Kristen Skinner Medicare Insurance Agent

Rick Boyd · Answer

Preventive services help you stay healthy, detect health problems early, determine the most effective treatments, and prevent certain diseases. Preventive services include exams, shots, lab tests, and screenings. They also include programs for health monitoring, and counseling and education to help you take care of your own health. There are approximately over 26 services and shots that are of no or little cost to the Medicare Member if your physician takes Medicare Assignment as payment. For a complete list go to Medicare.gov and search preventative services.

Answered by Rick Boyd on February 23, 2026

Broker Licensed in KY, AZ, CA & OH, TN, TX & UT

Answered by Rick Boyd Medicare Insurance Agent

Dana Dane · Answer

Please go to the Medicare link below for complete information.  You could also contact your agent or your insurance company.

https://www.medicare.gov/coverage/preventive-screening-services

Gus Karigan · Answer

With Original Medicare (Part B), many preventive services are covered at $0 cost to you if your provider accepts Medicare assignment and you meet eligibility guidelines. These include the one-time “Welcome to Medicare” visit, yearly Annual Wellness Visits, and screenings such as mammograms, colon cancer tests, cholesterol and diabetes screenings, depression screening, certain cancer screenings, bone density tests, and vaccines like flu, COVID-19, pneumonia, and hepatitis B (when risk criteria are met).

However, you may still have costs if your provider treats a new or existing medical issue during a preventive visit, orders additional non-preventive tests, or performs a procedure (for example, removing a polyp during a screening colonoscopy). In those cases, the Part B deductible and 20% coinsurance can apply. Routine dental, vision, hearing aids, and most full physical exams are not covered under Original Medicare, though some Medicare Advantage plans may offer limited additional benefits.

Betty McCarty · Answer

What Preventive Services Medicare Covers to Keep You Healthy

• Screenings
From diabetes to high blood pressure to cancers like breast, cervical, and colorectal—Medicare is basically that friend who insists, “Let’s just check, just in case.” These tests help catch issues early, when they’re easiest to treat.

• Vaccinations
Flu shot? Covered. Pneumonia vaccine? Covered. Hepatitis B? Also covered. Medicare Part B is basically your immune system’s hype squad.

• Annual Wellness Visits
This is your once a year chance to sit down with your provider and create a personalized prevention plan. It’s like a strategy meeting for your health—minus the boring PowerPoint slides.

• Counseling Services
Need help quitting smoking or managing weight? Medicare covers counseling that supports healthier habits and helps prevent chronic conditions. Think of it as a pep talk with medical credentials.

Cost & Coverage Details

• Many Preventive Services Cost You $0
If your provider accepts Medicare assignment, many preventive services are covered at 100%. That means no copay, no coinsurance, and no surprise bills sneaking into your mailbox like uninvited guests.

• Eligibility Rules Apply
Some services depend on your age, health history, or how long it’s been since your last screening. For example, certain tests are covered annually, while others are only covered every few years. Medicare likes to keep things organized—like a very health conscious calendar.

Valerie Schurman · Answer

well two things    one is look at medicare.gov to review them or if you have an advantage plan a lot of them are in the summary of benefits   

thanks 
val

Kathy Adams · Answer

This would be a Medicare Advantage Plan, which enhances your original Medicare Parts A & B. There are plans with a $0 cost per month. This gives you the extra benefits you are entitled to and deserve! A few examples include: Dental, vision, free gym membership, over-the-counter (OTC) benefits for daily need items (toothpaste, vitamins, etc) and so much more

Answered by Kathy Adams on May 20, 2025

Agent Licensed in NV & ND

Answered by Kathy Adams Medicare Insurance Agent

Vachik Chakhbazian · Answer

With Original Medicare (Parts A & B) and Medicare Advantage plans, many preventive services are covered at no cost to you. These include screenings, vaccines, and counseling services aimed at preventing or detecting health problems early.

Answered by Vachik Chakhbazian on April 10, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Gary Henderson · Answer

Preventative screenings are covered under Medicare and no charge. They want you to stay healthy! So your annual wellness visit mammograms pap smears colonoscopies things of that nature that would help prevent disease are covered

Answered by Gary Henderson on April 19, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Rodolfo Rojas · Answer

Medicare tries to focus on preventive care to keep the beneficiaries as healthy as possible.
The list of services is big, but they include annual wellness checkups, vaccines, cancer-preventing screenings, and more. .

Mel Stevens · Answer

Many preventive services are offered at zero cost to the insured. If you would like to know what is covered and what is not, I recommend you contact a professional like myself.

Sam Silva · Answer

free :  Annual Wellness Visit

If a preventive service leads to additional tests, treatments, or a diagnosis, you may have to pay.

Lillian Hill · Answer

Be sure to check with your medical providers to confirm coverage, acceptance, and that services are coded correctly. This helps prevent unexpected bills and ensures your benefits are applied the way Medicare intends.
You can also verify your coverage directly through Medicare.gov or by calling 1‑800‑MEDICARE (1‑800‑633‑4227), TTY 1‑877‑486‑2048, for confirmation of how a service should be covered.

Adam Morillo · Answer

Great question, Medicare covers many preventive services at no cost to you as long as your doctor accepts Medicare assignment. These include yearly wellness visits, cancer screenings like mammograms and colonoscopies, cardiovascular and diabetes screenings, depression checks, and vaccines such as flu, COVID-19, and pneumonia. However, you may still pay out-of-pocket if a preventive test turns into a diagnostic one—for example, if a polyp is found during a colonoscopy—or if your provider doesn’t accept Medicare assignment. You might also have costs for follow-up lab work or medications not covered under preventive care. To avoid surprise bills, always ask if a service is fully covered and if your provider accepts Medicare.

Answered by Adam Morillo on July 23, 2025

Broker Licensed in FL, AK, AL & 48 other states

Answered by Adam Morillo Medicare Insurance Agent

Larry Pereiro · Answer

There are 18 different preventative procedures, the most common is bone density testing, colonoscopy and mammogram.

Ray Rios · Answer

Hi, Ray here. There is No Such Thing as Free. Zero $0.00 Copay describes it best. There are things that you can do for Prevention that doesn't cost, such as, Preventive Screenings, Preventive Vision, Hearing and Dental. Mostly, what are your needs?

Answered by Ray Rios on November 8, 2025

Agent Licensed in AZ, CO, FL & KY, MO, NM & TX

Answered by Ray Rios Medicare Insurance Agent

Theodore Carpenter · Answer

Medicare pays for most all of the preventive tests and blood work. However, if something arises from the testing, you may have low out-of-pocket expenses related to the Part B deductible of $257.

Tammam Tayara · Answer

Medicare covers many preventive services at no cost to you, like annual wellness visits, certain vaccines, screenings for cancer, diabetes, and heart disease, and counseling for issues such as smoking cessation. These are free as long as your provider accepts Medicare and the service meets coverage guidelines. However, if additional tests or treatments are done during the visit, you may still have coinsurance or deductibles to pay.

Answered by Tammam Tayara on September 10, 2025

Agent Licensed in CA, NM, OR & TX

Answered by Tammam Tayara Medicare Insurance Agent

Dalyaness Martinez · Answer

Preventive services are vaccines, mammograms, physical check ups and more.  If you want, i can give you a comprehensive explanation on those.

Christopher DiBiase · Answer

Your preventative services are a yearly exam, screenings, HIV testing, mammograms, and vaccines. There is no cost; in some rare cases, there can be costs for office visits if you require specialized testing.

Answered by Christopher DiBiase on March 16, 2026

Broker Licensed in FL, AZ, NC, OH, SC & TX

Answered by Christopher DiBiase Medicare Insurance Agent

Collette Rance · Answer

Good morning.  Here is the listing that comes from Medicare for "preventative" services.  If you would like additional information about each service,

Abdominal aortic aneurysm screenings
Alcohol misuse screenings & counseling
Bone mass measurements
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screenings
Colorectal cancer screenings
Blood-based biomarker tests
Colonoscopies
Computed tomography (CT) colonography
Fecal occult blood tests
Flexible sigmoidoscopies
Multi-target stool DNA tests
Counseling to prevent tobacco use & tobacco-caused disease
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma screenings
Hepatitis B shots
Hepatitis B virus (HBV) infection screenings
Hepatitis C virus screenings
HIV screenings
Lung cancer screenings
Mammograms (screening)
Medical nutrition therapy services
Medicare Diabetes Prevention Program
Obesity behavioral therapy
One-time “Welcome to Medicare” preventive visit
Pre-exposure prophylaxis (PrEP) for HIV prevention
Prostate cancer screenings
Sexually transmitted infections screenings & counseling
Shots:
COVID-19 vaccines
Flu shots
Hepatitis B shots
Pneumococcal shots
Yearly "Wellness" visit

Debbie Coufal · Answer

There is an extensive list of preventative services that Medicare covers under Medicare Part B. You can find that list on Medicare.gov.

Robin Dall · Answer

Medicare does cover many preventive services at no additional cost when you meet the requirements and use providers who accept Medicare. Examples can include annual wellness visits, certain screenings like mammograms and colonoscopies, flu shots, and many recommended vaccines under Part D.

What people often do not realize is that “free” preventive care can turn into regular medical costs if a problem is found or extra treatment is needed during the visit. For example, if a screening becomes diagnostic or you receive additional testing or treatment, you may still have deductibles, copays, or coinsurance depending on your coverage.