Preventive care
A Guide to Medicare Preventive Services
Medicare covers many preventive services, but “covered” does not always mean every related visit or test is free. Eligibility, frequency, provider participation, and the difference between a preventive screening and a diagnostic service can affect what you pay. Confirm the exact service, timing, and billing before the appointment.
Call Gala Health · 934-222-5466When preventive care can create additional costs
Original Medicare covers a “Welcome to Medicare” preventive visit during the first 12 months you have Part B and an Annual Wellness Visit after you have had Part B for more than 12 months. These visits are not the same as a routine physical. Many screenings have no cost when you meet Medicare’s criteria and the provider accepts assignment, but follow-up tests or treatment may involve deductibles or coinsurance.
Practical checklist
Check eligibility and service frequency.
Ask whether the provider accepts assignment.
Distinguish Wellness visits from routine physicals.
Ask whether follow-up work may create cost sharing.
Preventive and diagnostic care are not the same
Ask the provider whether the visit is preventive or diagnostic and whether follow-up tests could create cost sharing.
Before the appointment
Confirm eligibility and timing
Confirm the exact preventive service, Medicare frequency rule, and whether the provider accepts assignment before the appointment.
Ask about follow-up costs
Separate no-cost preventive care from diagnostic follow-up, which may involve deductibles, copays, or coinsurance.
Check Medicare’s current coverage rules
Use the current Medicare preventive-services list to check eligibility and frequency. Before the visit, ask the office whether it accepts Medicare assignment and whether anything scheduled may be billed as diagnostic care. You may also want our Medicare plan review checklist.
Educational information only; not legal or medical advice. Plan availability and benefits vary by location and eligibility.
Organize your preventive-care questions
Bring the preventive services you are considering, your Part B start date, and provider questions to a focused Medicare review.
Request a plan review