Key Takeaways
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Medicare covers a wide range of preventive services in 2025, including screenings, counseling, and annual wellness visits—most at no additional cost to you if eligibility criteria are met.
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Using preventive care under Medicare can detect health issues early, reduce long-term healthcare expenses, and significantly improve your quality of life.
Medicare’s Commitment to Prevention in 2025
Preventive care is no longer a secondary benefit under Medicare—it is a core part of your health coverage in 2025. Medicare recognizes that early detection and routine monitoring can stop many health issues before they turn serious. That’s why you now have access to more preventive services than ever before.
This focus on prevention isn’t just about reducing costs. It’s about helping you live longer, healthier, and more independently. But here’s the catch: you have to actively use these services to benefit from them.
What Preventive Services Medicare Covers
Medicare covers a wide list of preventive care services. These include screenings, vaccinations, and counseling sessions—all designed to catch or prevent illness early. In 2025, you can expect coverage for:
Screenings
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Cardiovascular Disease: A cardiovascular screening is covered once every 5 years.
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Colorectal Cancer: Multiple screening options, such as stool tests (annually), flexible sigmoidoscopy (every 4 years), and colonoscopy (every 10 years), depending on your risk profile.
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Mammograms: Covered once every 12 months for women age 40 and older.
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Prostate Cancer: Prostate-specific antigen (PSA) test and digital rectal exam once a year for men age 50 and older.
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Lung Cancer: Annual low-dose CT scan for adults aged 50 to 77 who meet smoking history criteria.
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Diabetes: Screening available up to twice per year if you are considered at risk.
Vaccinations
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Influenza: Annually.
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Pneumococcal: Typically two doses in a lifetime.
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Hepatitis B: For those at medium to high risk.
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COVID-19: Updated vaccines and boosters covered under Medicare.
Counseling and Preventive Therapies
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Tobacco Use Cessation: Up to 8 counseling sessions per year.
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Alcohol Misuse Counseling: Annual screening and up to four brief counseling sessions for those at risk.
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Obesity Screening and Counseling: Ongoing behavioral counseling sessions covered for individuals with a BMI of 30 or more.
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Depression Screening: Annual screening by your primary care provider.
Your Welcome to Medicare and Annual Wellness Visits
If you’re newly enrolled in Medicare, you’re eligible for the “Welcome to Medicare” visit within your first 12 months. This is a one-time preventive physical exam that helps establish a health baseline. It includes:
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A review of your medical and social history
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Basic vision test
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Height, weight, and blood pressure measurement
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A written plan for future screenings and preventive services
After your first year, you can schedule an Annual Wellness Visit once every 12 months. This is not a full physical exam but rather a tailored conversation about your health risks, current conditions, and steps you can take to stay well. It includes:
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Personalized health advice
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Cognitive impairment assessment
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Advanced care planning discussions
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Health risk assessment questionnaire
These wellness visits are key opportunities to develop a proactive plan with your doctor for maintaining your health.
What You Might Pay—and What You Won’t
Most preventive services are covered without any deductible or coinsurance, as long as your provider accepts Medicare assignment and you meet eligibility requirements. However, if additional tests or procedures are performed during your visit that are not preventive, you could be responsible for part of the cost.
For example:
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A screening colonoscopy is fully covered, but if a polyp is found and removed, the procedure becomes diagnostic, and you may owe coinsurance.
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If your provider performs a diagnostic follow-up test due to an abnormal screening result, standard Part B cost-sharing applies.
Always ask in advance if a service is preventive or diagnostic.
Why You Shouldn’t Skip Preventive Care
Skipping preventive care might seem harmless, especially when you feel fine. But many serious conditions—like hypertension, cancer, and diabetes—develop silently. By the time symptoms appear, they can be harder to manage.
Here’s why preventive care makes a real difference in 2025:
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Improved Outcomes: Early detection means simpler treatments and higher survival rates.
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Lower Costs: Preventing illness or catching it early can avoid expensive treatments later.
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Peace of Mind: Staying on top of your health reduces anxiety and increases confidence.
How to Get Started in 2025
It’s never too late—or too early—to take advantage of your preventive benefits. Here’s how to make the most of what Medicare offers this year:
1. Schedule Your Wellness Visit
Call your doctor and schedule your Annual Wellness Visit. It’s the first step in creating a long-term preventive care plan tailored to your needs.
2. Talk to Your Doctor About Screening Schedules
Don’t wait for your provider to bring it up. Ask directly:
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Am I due for any screenings?
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Are there vaccines I need?
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Do I qualify for counseling or behavioral health services?
3. Keep a Personal Preventive Health Record
Track what screenings and vaccines you’ve received and when the next ones are due. Medicare’s Blue Button tool or your provider’s online portal can help.
4. Make Use of Online Resources
Medicare.gov offers a Preventive Services Checklist. You can download it, fill it out, and bring it to your next visit.
5. Ask if You Need Prior Authorization
While most preventive services don’t require prior approval, some follow-up tests or therapies might. Clarify this before undergoing any tests outside your routine coverage.
What If You Have Medicare Advantage?
Medicare Advantage plans must cover all preventive services offered under Original Medicare. However, you may need to follow your plan’s network and referral rules. Some plans may also offer additional preventive benefits, such as nutrition counseling or fitness programs.
But remember: you should never have to pay extra for preventive care that is included in Original Medicare unless you go outside the plan’s guidelines. If you’re unsure, contact your plan or speak with a licensed agent listed on this website.
Preventive Coverage Is Wasted If You Don’t Use It
You’ve paid into Medicare. Now Medicare is ready to pay for services that could help you avoid serious illness or delay chronic conditions. But these benefits don’t help if they’re ignored.
So don’t wait until symptoms appear. Book your wellness visit. Ask questions. Get screened. Get vaccinated. These small steps today can mean fewer problems—and lower costs—tomorrow.
If you need help understanding which preventive services you’re eligible for, reach out to a licensed agent listed on this website. They can help you find a provider, explain what’s covered, and guide you through your options.
