Medicare & Annual Health Checks

Q:  I know Medicare pays for an annual health check, however, I don’t always know when I’ve last had my wellness check-up.  Is it always free?

A: Medicare pays for many preventive services when the services are offered by a doctor or other qualified health care provider who accepts Medicare assignment.

You can get a “Welcome to Medicare” visit during the first 12 months that you have Medicare. This includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care if needed.

Medicare also covers a yearly “Wellness” visit. You can get this visit if you’ve had Part B for longer than 12 months, and it’s covered every 12 months.

Be sure to tell your health care office exactly what type of visit you are scheduling when you make the appointment.

A very valuable tool for Medicare beneficiaries is www.mymedicare.gov. On this website, you can check when your last preventive service was provided.

The following are preventive services typically covered by Medicare at no cost to you:

  • Welcome to Medicare Visit
  • Yearly Wellness Visit
  • Pap Test and Pelvic Exams
  • Pneumococcal Shot
  • Flu Shots
  • Alcohol Misuse Screening and Counseling
  • Hepatitis B Shots
  • Tobacco Use Cessation
  • Counseling
  • Diabetes Screenings
  • Mammogram Screening
  • Abdominal Aortic Aneurysm
  • Screening
  • Sexually Transmitted Diseases
  • Infections Screening
  • HIV Screenings
  • Bone Mass Measurements

Cardiovascular Screenings: tests covered for cholesterol, lipid, and triglyceride levels every 5 years.

Cardiovascular Disease (Behavioral Therapy): one visit per year with your primary care doctor covered to help lower your risk for cardiovascular disease.

Colorectal Cancer Screenings: If you’re 50 or older, or are at high risk for colorectal cancer, one or more of these tests covered: fecal occult blood test, flexible sigmoidoscopy, screening colonoscopy, and barium enema.

Medical Nutrition Therapy Services: covered along with certain related services if you have diabetes or kidney disease, or you have had a kidney transplant in the last 36 months, and you’re referred by your medical provider.

The following are preventive services are typically covered by Medicare but will require coinsurance and/or deductible:

  • Prostate Cancer Screenings
  • Glaucoma Tests
  • Depression Screenings

Diabetes Self-Management Training: covered for people with diabetes with a written order from a doctor or other medical qualified health care provider.

If you have questions about Medicare, call SHIP at 1-800-452-4800, 1-866-846-0139 TDD or online at www.medicare.in.gov.