Medicare Preventive Screenings: What’s Covered, How Often and at What Cost

Original Medicare Part B covers a long list of preventive screenings, from mammograms and colorectal cancer tests to diabetes, heart disease and depression checks. Most cost you $0 when your provider accepts assignment, but each has its own rules about how often it is covered and who qualifies. Knowing those rules helps you plan ahead and avoid unexpected bills.

How Medicare preventive screenings work

Preventive screenings look for health problems early, often before you have any symptoms, when they may be easier to manage. Under Original Medicare, most of them are covered by Part B. You usually pay nothing for the screening itself if your doctor or other provider accepts assignment, meaning they agree to take the Medicare-approved amount as full payment.

Three questions decide whether a particular screening is covered for you:

• How often? Each test has a frequency limit. A test done sooner than allowed may not be covered as a screening.
• Do you qualify? Some tests are for everyone in an age group, while others are only for people at higher risk.
• Is it still a screening? If a test is ordered because you already have symptoms, or if a problem is found and treated during the test, it may be billed as diagnostic care, with your usual Part B costs.

Cancer screenings

Colorectal cancer screening options

Colorectal screening has the most choices, which is why it is worth discussing with your doctor. Options include stool tests, such as a yearly fecal immunochemical test (FIT) or a multitarget stool DNA test every 3 years, as well as CT colonography, flexible sigmoidoscopy and colonoscopy.

A screening colonoscopy is covered every 10 years if you are not at high risk, or every 24 months if you are. One helpful rule: if a stool test comes back positive, the follow-up colonoscopy is also covered as a screening rather than as a diagnostic test.

Heart, diabetes and other health screenings

Bone mass measurement checks for thinning bones, which matters for fall injuries. Our guide on calcium and vitamin D after 50 covers the nutrition side of bone health.

Counseling services

Part B also covers several counseling services that support prevention:

• Obesity counseling if your body mass index is 30 or higher. You can check yours with our BMI calculator, and our guide to BMI for older adults explains its limits later in life.
• Medical nutrition therapy if you have diabetes or kidney disease.
• Tobacco cessation counseling, up to 8 sessions a year.

Vaccines

Several vaccines are covered under Part B: the flu shot once per flu season, pneumococcal vaccines, COVID-19 vaccines, and hepatitis B vaccines for people at medium or high risk. Other recommended adult vaccines, such as shingles and RSV vaccines, are covered under Medicare Part D drug plans at $0 cost-sharing. That difference matters for where you get them: Part D vaccines are often easiest to get at a pharmacy that is in your drug plan's network. For more on how Part D works, see our guide to Medicare Part D costs in 2027.

A worked example: one year of screenings

Here is how the rules might apply to a hypothetical 68-year-old man with Original Medicare whose providers all accept assignment. He has no symptoms and quit smoking long ago. The dollar figure below is an example only, because Medicare-approved amounts vary by service and location.

• PSA blood test: once a year, $0.
• Digital rectal exam: once a year, 20% coinsurance. If the Medicare-approved amount were $40, his share would be 20% × $40 = $8, and his Part B deductible may also apply.
• Colorectal screening: he chooses a yearly FIT stool test at $0. If it ever came back positive, the follow-up colonoscopy would be covered as screening.
• Cardiovascular blood tests: last done three years ago, so not due again for two more years under the every-5-years rule.
• Flu shot: once this flu season under Part B, $0. His shingles vaccine would go through his Part D plan at $0 cost-sharing.

In this example his only screening cost is the coinsurance on the rectal exam. The same approach, checking frequency, eligibility and cost for each test, works for anyone.

Questions to ask before you book

A short phone call before a screening can save money and stress later. These questions are worth asking the office that will do the test:

• "Do you accept Medicare assignment?" The $0 cost for most screenings depends on it.
• "Will this be billed as a preventive screening?" If the order mentions symptoms, the test may be coded as diagnostic instead.
• "When was my last one?" If you are not sure, your doctor's office or your Medicare account records can help you avoid booking a test before it is due again.
• "Is a referral or counseling visit needed first?" Lung cancer screening requires a counseling visit, and abdominal aortic aneurysm screening requires a referral.
• "Is anything else planned for the same appointment?" Extra tests or treatment may come with their own costs.

It also helps to remember that a screening is a starting point, not a verdict. A result outside the normal range usually leads to a conversation with your doctor about next steps, which might include further tests. Keeping copies of your results makes those conversations easier, especially if you see more than one doctor.

How to keep track of what is due

With so many different time frames, it is easy to lose track. A few habits help:

• Use your Medicare Annual Wellness Visit to review which screenings are due and get a written schedule.
• Keep a simple record of the date and result of each screening.
• Before booking, ask whether the test will be billed as a screening and whether the provider accepts assignment.
• If you have a Medicare Advantage plan, check with the plan, because rules about networks and referrals may differ.
• If you have questions about your coverage, you can call Medicare at 1-800-633-4227.

This guide is general health information for education. It is not medical advice and does not replace a visit with your doctor or pharmacist. Never start, stop or change a medicine without talking to them. In an emergency call 911. Spotted an error? Let us know.