Preventive Services for People with Medicare
Medicare’s coverage includes a one-time initial physical exam after enrolling in Medicare and screening tests for heart disease and diabetes. Here is some additional information about these services.
Initial Physical Exam
If your Medicare Part B coverage began on or after January 1, 2005, Medicare will cover a one-time initial preventive physical exam, also called a "Welcome to Medicare" exam. This exam must occur within the first six months that you have coverage. The exam will include:
- An evaluation of your health
- Information about the preventive services you may need – i.e. shots or screenings
- Referrals for additional care, if you need it. (You will need to pay 20% of the Medicare-approved amount after your yearly Part B deductible for this service.)
During the exam, your doctor will review your medical history and check your blood pressure, height and weight. Your doctor may also give you a vision test and an electrocardiogram, a test that records the electrical activity of the heart. Your doctor will also make sure that you are up to date with all your shots.
In addition, your doctor will give you information to help you prevent disease and maintain or improve your health. If you need additional services, you will get a written plan so that you know which screenings and other preventive services you should get.
Be prepared for your exam. Bring the following items with you when you go:
- A list of prescription drugs that you currently take
- Medical records (if you are seeing a new doctor)
- Family health history information: any details you give your doctor can help determine if you are at risk for specific diseases
Screenings for Heart Disease and Diabetes
Medicare also covers screenings for heart disease, also known as a cardiovascular screenings, which check your cholesterol level and other blood fat (lipid) levels. Medicare will pay for these tests every five years. You do not have to pay coinsurance or the Part B deductible for this screening.
If you are at risk for getting diabetes, Medicare also covers a blood sugar screening to check for diabetes. You are considered at risk if you have any of the following:
- High blood pressure
- Dyslipidemia (history of abnormal cholesterol and triglyceride levels)
- Obesity or a history of high blood sugar
Depending on your health, Medicare may pay for up to two screenings each year. Also, you will not have to pay coinsurance or the Part B deductible for this screening. Medicare may also cover certain supplies (for example, glucose testing monitors and strips) and training so that you can better manage self-administered treatments (for example, insulin shots).
AARP Resources
AARP on Medicare
A series of articles to help you better understand your Medicare options.
Health Conditions
Information designed to help you take charge of your health.
Researching Your Health
This online seminar points you to reliable resources to learn about health issues.
Becoming a Partner in Your Health Care
Suggestions on how to become an active partner in your health care.
Staying Healthy—Practice Prevention
What is preventive care, and what kind of preventive care do people age 50 and older need to discuss with their doctors?
Additional Resources
Preventive Benefits for People with Medicare
Information about preventive services that are available to people with Medicare.
Medicare Personal Plan Finder
Information on the insurance companies that sell Medigap policies in your area and the range of premiums they charge.
State Health Insurance Assistance Program (SHIP)
This important Medicare partner offers free one-on-one health insurance counseling for people with Medicare. Search for SHIP sites under “Organizations."
