Here's a summary of the preventive tests, screenings, vaccinations and exams that Medicare covers at no cost to you. For complete details, reference your plan documents.
Remember, the services listed here are only preventive when you have no symptoms—if your doctor orders a test or screening because you are having symptoms, the test is "diagnostic." That means you may have to pay a share of the cost, depending on your Medicaid status.
Who is covered: Medicare members with certain risk factors for AAA
When: Once in a lifetime, with a referral from your doctor
Who is covered: All Medicare members
When: Annually
If you screen positive for alcohol misuse, you can get up to four in-person counseling visits per year (you must be alcohol free during counseling).
Who is covered: All Medicare members. If you've had Medicare Part B (Medical Insurance) for longer than 12 months, you can get a yearly "Wellness" visit to develop or update a personalized prevention plan based on your current health and risk factors. Advanced Care Planning is an optional preventive service at no cost to the member only when given with an AWV. When furnished not during the AWV a cost share would apply to the member.
When: Once per calendar year
Who is covered: Medicare members who are at risk of losing bone mass, risk of osteoporosis, glucocorticoid therapy for more than 3 months or primary hyperparathyroidism
When: Once every 24 months or more frequently if medically necessary
Who is covered: All female Medicare members
When: Breast exams: Every 24 months
Screening mammograms: One baseline at 35-39 years old, annually 40+
Who is covered: All Medicare beneficiaries without apparent signs or symptoms of cardiovascular disease
When: Annually
Who is covered: All Medicare members
When: Once every 5 years, when ordered by a doctor
Who is covered: All female Medicare members
When: Pap test & pelvic screenings: Every 2 years
Pap test annually if at high risk of cervical cancer or if you've had an abnormal Pap test within the past 3 years and are of childbearing age
Who is covered: All Medicare members age 50 and older, but there is no minimum age for having a covered screening colonoscopy.
When: Consult with your physician on the type of screening you need and the frequency (anywhere from 12-120 months): Guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), DNA based colorectal screening, flexible sigmoidoscopy, colonoscopy, barium enema, Cologuard
Who is covered: All Medicare members
When: Annually
Who is covered: Medicare members at risk or with pre-diabetes
When: Up to 2 tests per year with referral from your doctor
Who is covered: Medicare members with diabetes
When: As prescribed by your doctor
Frequency: Initial year: Up to 10 hours of initial training within a continuous 12-month period
Subsequent years: Up to 2 hours of follow-up training each calendar year after the initial 10 hours of training has been completed
Who is covered: Medicare members with diabetes or a family history of glaucoma, African-Americans age 50 or older, and Hispanic-Americans age 65 or older
When: Annually
Who is covered: Medicare covers HBV infection screenings if you meet certain conditions
When: Annually
Who is covered: Medicare members at high risk due to: Current or past history of illicit drug use, or blood transfusions prior to 1992, or born between 1945-1965
When: Once per lifetime, or annually for certain people at risk
Who is covered: All Medicare members between the ages of 15 and 65. Those at an increased risk less than age 15 or older than age 65.
When: Annually or up to 3 times during a pregnancy
Must be performed along with a pap test.
Who is covered: All asymptomatic female Medicare members 35-65 years old
When: Once every 5 years
Who is covered: All people with Medicare
Details: Medicare covers FDA-authorized COVID-19 vaccines. For the latest information, visit the Priority Health COVID-19 vaccine information page.
Who is covered: All people with Medicare
When: Once each flu season
Who is covered: All people with Medicare
When: Most people only need one shot once in their lifetime. A different, second shot, is covered 11 months after you get the first shot. Talk with your doctor or other qualified health care provider to see if you need these shots.
Who is covered: Members who are at medium or high risk for Hepatitis B
When: Three shots are needed for complete protection. Check with your doctor about when to get these shots if you qualify to get them.
Who is covered: Medicare members who meet all of these criteria:
When: Annually, when ordered by your doctor
Who is covered: Certain members who have a referral from their treating physician, diagnosed with diabetes or renal disease or who has had a kidney transplant within the last 36 months.
When: 3 hours of counseling the first year and 2 hours the following year(s). Services delivered by a registered dietician or nutrition professional.
Who is covered: Medicare members that could prevent or delay type 2 diabetes.
When: Once per lifetime
Who is covered: Medicare members with BMI greater than 30
When: Consult with your physician; Medicare covers behavioral therapy sessions to help you lose weight. 15-30 minute sessions (depending on individual or group counseling) may be covered if you get in a primary care setting (like a doctor's office), where it can be coordinated with your other care and a personalized prevention plan.
Who is covered: Medicare members with BMI greater than 30
When: Consult with your physician; Medicare covers behavioral therapy sessions to help you lose weight. 15-30 minute sessions (depending on individual or group counseling) may be covered if you get in a primary care setting (like a doctor's office), where it can be coordinated with your other care and a personalized prevention plan.
Who is covered: Medicare members at increased risk for STIs, or pregnant women
When: Every 12 months, or at certain times during pregnancy
Who is covered: All Medicare members who use tobacco
When: Up to 8 visits in a 12-month period
Who is covered: All Medicare members
When: Within the first 12 months you have Medicare Part B
Y0056_400040062506_M_2025_B Last updated 1152025
Priority Health has HMO-POS and PPO plans with a Medicare contract. Enrollment in Priority Health Medicare depends on contract renewal. This information is not a complete description of benefits. Call 888.389.6648, option 3 (TTY users call 711) for more information.