Google Plus Logo
Home Nursing Services
At Home Therapies
Home Care FAQ
Bereavement & Grief
Hospice & Alzheimers
Hospice Pet Therapy
Special Care Programs
Your Care Team
Specialized Home Care
Patient-Centered Dementia Care
Congestive Heart Failure
Hypertension / Blood Pressure
Coronary Artery Disease
Mental Health and Depression
Home Care Support for Multiple Sclerosis
Paraplegia and Quadriplegia
Traumatic Brain Injury
Caring Brands International
Aging in Place
Questions to Ask Before Hiring a Home Health Aide
8 Dietary Tips for Improving Senior Heart Health
Talking About Substance Abuse as a Caregiver
How to Take Care of Aging Hair
4 Ways to Improve Indoor Air Quality for Seniors
Designing Outdoor Living Areas for Seniors
Getting A Grip: How and Where to Install Bathroom Grab Bars
Keeping Active: Tips for Senior Gardening
Alzheimer's and Dementia
Calculating the Cost
Certified Senior Advisors
Consumer Health Care Education
Advisor Care Giving Guide
Care in a Residential Facility
Check Your Home Care IQ
Elder Care Communities
Medicare and Home Care
Senior Care Resources
Senior Care Scams
Signs That Care At Home is Needed
Long Term Care
Mobility in Seniors
Home Safety Checklist
Home Safety Tips
Medications and Fall Risk
Reduce the Risk of Falling
Risk of Falling
Visiting the Doctor and Discussing Falls
What to Do If Someone Falls
Elder Care Videos
Hiring Your Own Caregivers
Family Care Giving Facts
Information for Seniors
Long Distance Caregiving
Starting the Conversation
The Stress of Family Caregiving
Taking Care Of Yourself as a Family Caregiver
Home Care Technology
Hospice Fact or Myth
Exercise and Older Adults
Tips for Lowering Blood Pressure
Seniors and Zika Virus
Stories From Home
Transitioning from a Facility
Independent Living Assessment
Where are you looking for Care?
How Medicare Covers Preventive Health Services
How Medicare Covers Preventive Health Services
Posted: 2/16/2017 8:07 AM by
Dear Savvy Senior,
Does Medicare cover 100 percent of all preventive health care screenings? I’m due to get a colonoscopy and a few other tests, but I want to find out if I’ll have to pay anything before I proceed.
New to Medicare
Medicare currently covers a wide array of free preventive and screening services to help you stay healthy, but not all services are completely covered.
You also need to be aware that the repeal of the Affordable Care Act (aka Obamacare) – which helps financially support Medicare – may very well cause these free preventive services to be eliminated in the future. But in the meantime, here’s how it works.
Free Preventive Services
Currently, most of Medicare’s preventive services are available to all Part B beneficiaries for free, with no copays or deductibles, as long as you meet basic eligibility standards. Mammograms; colonoscopies; shots against flu, pneumonia, and hepatitis B; screenings for diabetes, depression, and heart conditions; and counseling to combat obesity, alcohol abuse, and smoking are just some of Medicare’s lengthy list of covered services. But to get these services for free, you need to go to a doctor who accepts Medicare “on assignment,” which means he or she has agreed to accept the Medicare approved rate as full payment.
Also, the tests are free only if they’re used at specified intervals. For example, prostate cancer PSA tests, once every 12 months for men over 50; or colonoscopy, once every 10 years, or every two years if you’re at high risk.
Medicare also offers a free “Welcome to Medicare” exam with your doctor in your first year, along with annual wellness visits thereafter. But don’t confuse these with full physical examinations. These are prevention-focused visits that provide only an overview of your health and medical risk factors and serve as a baseline for future care.
For a complete list of services along with their eligibility requirements, visit
and click on the “What Medicare Covers” tab at the top of the page, followed by “Preventive & screening services.”
You also need to know that while the previously listed Medicare services are completely free, you can be charged for certain diagnostic services or additional tests or procedures related to the preventive service. For example, if your doctor finds and removes a polyp during your preventive care colonoscopy screening, the removal of the polyp is considered diagnostic and you will likely be charged for it. Or, if during your annual wellness visit, your doctor needs to investigate or to treat a new or existing problem, you will probably be charged here too.
You may also have to pay a facility fee depending on where you receive the service. Certain hospitals, for example, will often charge separate facilities fees when you are receiving a preventive service. And, you can also be charged for a doctor’s visit if you meet with a physician before or after the service.
To eliminate billing surprises, talk to your doctor before any preventive service procedure to find out if you may be subject to a charge and what it would be.
Cost Sharing Services
Medicare also offers several other preventive services that require some out-of-pocket cost sharing. With these tests, you’ll have to pay 20 percent of the cost of the service, after you’ve met your $183 Part B yearly deductible. The services that fall under this category include glaucoma screenings, diabetes self-management trainings, barium enemas to detect colon cancer, and digital rectal exams to detect prostate cancer.
Medicare Advantage Members
If you have a Medicare Advantage plan, your plans are also required to cover the same free preventive services as original Medicare as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.