Medicare preventive services are health care services designed to keep you healthy, prevent illness, and detect medical problems early. They include screenings for things like cancer, diabetes, and heart disease, as well as health and wellness counseling, and a yearly wellness visit.

Preventive services are covered by Medicare Part B (Medical Insurance) and Medicare Advantage (Part C) plans. These services are free once you’re enrolled, but some coverage rules apply. Before getting help from Medicare’s preventive services, it is important to know what is covered as well as costs you may have to pay.

How can Medicare Prevention Services help you?

Medicare preventive services include many types of care that help you stay healthy and lower your chances of developing health problems in the future. Medicare groups these services into six main categories, each offering specific types of care:

  • Wellness visits: This includes annual doctor visits, initial physical exams, and the Medicare Annual Wellness Visit (AWV).
  • Shots and vaccines: Immunizations covered include those for pneumonia, the flu, Hepatitis B and COVID.
  • Tests and screenings: Covered tests include ultrasounds, bone density tests, heart health screenings, mammograms, eye exams, prostate cancer exams, and more.
  • Diabetes services: This category covers blood sugar tests, glucose tolerance testing, and education or resources to help manage diabetes.
  • Counseling and therapies: Services include counseling to prevent or stop tobacco use, screening for alcohol misuse, therapy for heart disease and obesity, and nutrition therapy for diabetes and kidney disease.
  • Mental health services: Medicare covers depression screenings and some mental health treatments like counseling for substance use, cognitive assessments, family counseling, and therapy sessions.

How much do Medicare Preventive Services cost?

Most Medicare preventive services are covered under Medicare Part B and Medicare Advantage (Part C). Once enrolled, these covered services are provided at no cost to you. However, your overall out-of-pocket costs can vary depending on the following:

Your plan

For Medicare Part B, you must pay a monthly premium. In 2025, the premium is $185 a month for most people. Regardless of whether you have Original Medicare or Medicare Advantage (Part C), which includes Part B Coverage, you will pay your Part B premium. Medicare Advantage plans are offered by private insurance companies, so they may have additional premiums on top of your Part B premium.

How often you get preventive services

Some preventive services are only offered a certain number of times each year, such as screenings, doctor’s visits, or counselling sessions. If you need these services more often than Medicare allows, you will have to pay the full cost for them. You can find out how often certain preventive services are covered by reading Medicare’s Guide to Preventive Services.

Provider must accept Medicare payment

For Medicare to pay for your care, the doctor or health care provider must “accept assignment.” This means they agree to take the Medicare-approved amount as full payment for the service.  Visit this Medicare site to learn more about what it means for a provider to accept assignment.

Using providers in your plan’s network

If you have a Medicare Advantage (Part C) plan, you usually need to get care from doctors, pharmacies, and hospitals that are in your plan’s approved network. Using providers outside the network may mean your care won’t be covered.

To learn more about the cost of preventive services, you can visit the Medicare website which provides details on plan pricing and what’s covered.

What is not covered under Medicare’s Prevention Services?

While Medicare covers many preventive care services, there are some important things it does not pay for. Medicare Part B usually does not cover most dental, vision, and hearing care. This means regular services like teeth cleanings, X-rays, eye exams, and hearing tests are not included. However, some Medicare Advantage (Part C) plans may offer these non-Medicare benefits, so check your plan to see if you have coverage.

Other services that Medicare preventive benefits don’t cover include:

  • Care received outside the United States
  • Chiropractic care
  • Cosmetic or elective surgeries
  • Non-preventive vaccines
  • Routine physical exams each year, except for the official Medicare Wellness Visit
  • Tests or screenings that your doctor deems unnecessary or not medically needed

Get help paying for Medicare costs

If you need help paying for Medicare, there are several programs and options that can help reduce the cost and make health care coverage more affordable:

  • Medigap (Medicare Supplement Insurance): This is extra insurance you buy from private companies to help cover some out-of-pocket costs like copayments and coinsurance. You typically must have both Medicare Part A and Part B to buy Medigap.
  • Medicaid: If your income is low, you might qualify for Medicaid along with Medicare. People with both are called “dually eligible.” Medicare pays first for covered services, and Medicaid helps pay remaining costs after Medicare and any other insurance.
  • Medicare Savings Programs: These programs help pay your Medicare Part A and Part B premiums, and may also cover deductibles, coinsurance, and copayments. You must apply for these programs through your state. There are four types:
    • Qualified Medicare Beneficiary (QMB)
    • Specified Low-Income Medicare Beneficiary (SLMB)
    • Qualifying Individual (QI)
    • Qualified Disabled and Working Individuals (QDWI)

Note: While there are four types of Medicare Savings Programs, only the Qualified Medicare Beneficiary (QMB) will cover deductibles, coinsurance, and copayments.

See if you qualify for assistance

Medicare’s preventive services help you stay healthy by catching health issues early and keeping you well. If you need help covering the cost of Medicare, the site you are currently on can help. Our BenefitsCheckUp eligibility screening tool helps you find programs that can lower your Medicare costs. The tool also guides you step-by-step on how to apply for these programs, making it easier to get the support you need.