How Often are Medicare Preventive Screenings Covered?

Medicare provides it’s members with preventive and screening services coverage, although some are covered annually, while others occasionally or even one-time.

Below is a list of the covered preventive services and how often they are covered.

Abdominal aortic aneurysm screening – Covered by Part B.  A one-time abdominal aortic aneurysm ultrasound. You must receive a referral for this test.  Who is eligible:  No cost for this procedure.

Alcohol Misuse Screening and Counseling – Medicare Part B covers this once per year.  No cost.

Bone Density – Part B covers this once every 24 months, and more often is medically necessary.
All qualified people with Part B who are at risk for osteoporosis are eligible who meet certain conditions.

Cardiovascular Disease Screenings – covers screening blood tests for cholesterol, lipid, and triglyceride levels every 5 years. These screenings include blood tests and help detect conditions that may lead to a heart attack or stroke.  No cost.

Cardiovascular Disease (behavioral therapy) – Medicare covers one visit per year with your primary care doctor to help you lower your risk for cardiovascular disease. Your doctor may discuss aspirin use, check your blood pressure, and give you tips to make sure you’re eating well.

Cervical Cancer Screenings – covers Pap tests and pelvic exams to check for cervical and vaginal cancer. As part of the exam, Part B also covers a clinical breast exam to check for breast cancer. Part B covers these screening tests:

  • Once every 24 months for all women
  • Once every 12 months if doctor recommended.

Colorectal Cancer Screenings – covers several types of colorectal cancer screening tests. These tests help find precancerous growths or find cancer early, when treatment is most effective.

All people age 50 or older with Part B are covered. People of any age are eligible for a colonoscopy.  No cost.

Depression Screenings – Medicare covers one depression screening per year. No cost for this screening.

Diabetes Screenings – covers screenings to check for diabetes. You may be eligible for 2 diabetes screenings each year.

Diabetes Self-Management Training – covers outpatient diabetes self-management training (DSMT) to teach you to cope with and manage your diabetes. It includes tips for eating healthy, being active, monitoring blood sugar, taking drugs, and reducing risks. Medicare may cover up to 10 hours of initial DSMT.

Glaucoma Tests – covers a glaucoma test once every 12 months for people at high risk for glaucoma. An eye doctor who’s legally allowed to do this test in your state must do or supervise the screening.

Hepititis C Screening – Medicare covers one Hepatitis C screening test. Medicare also covers yearly repeat screening for certain people at high risk.

HIV Screening – covers HIV (Human Immunodeficiency Virus) screenings. HIV is the virus that can lead to AIDS (Acquired Immunodeficiency Syndrome). Medicare covers this test once every 12 months for people who meet certain guidelines. Medicare also covers this screening up to 3 times during a pregnancy.

Lung Cancer Screening – covers a lung cancer screening with Low Dose Computed Tomography (LDCT) once per year.

Mammograms – Medicare Part B covers a:  Screening mammogram once every 12 months (11 full months must have passed since the last screening).  And diagnostic mammogram when medically necessary.

Nutrition therapy Services – covers medical nutrition therapy (MNT) services and certain related services. A Registered Dietitian or nutrition professional who meets certain requirements can provide these services, but only your doctor can refer you for these services.

Obesity Screening – Medicare covers behavioral counseling sessions to help you lose weight. This counseling may be covered if you get it in a primary care setting (doctor’s office).

Prostate Cancer Screenings – covers: Digital rectal exam: Once every 12 months and prostate specific antigen (PSA) test: Once every 12 months

Sexually Transmitted Infections – covers sexually transmitted infection (STI) screenings.  STI screenings are covered once every 12 months or at certain times during pregnancy.

Welcome to Medicare Visit – You can get this visit only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services.

Yearly Wellness Exam – If you’ve had Part B for longer than 12 months, you can get this visit to develop or update a personalized prevention help plan. This plan is designed to help prevent disease and disability based on your current health and risk factors.

Shots – Flu, Hepatitis B, Pneumococcal Shots.

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

QUICK LINKS:

John Conner
916-682-1117
john@johnconner.com

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Author: John

Medicare Options along with Individual and Group International Medical Insurance Options.

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