Medicare Preventive Health Benefits


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Preventive Service How Often Allowed Additional Details
Abdominal Aortic Aneurysm Screening Ultrasound Once with certain risk factors and referral from practitioner Covered at 100%
Alcohol Misuse Screening and Counseling Screening: Once per year
Counseling: 4 times per year for those who screen positive
Covered at 100%
Annual Wellness Visit (Not a full physical, prevention planning only) Annually 12 months after Part B effective date Covered at 100%
Bone Mass Measurement Every 2 years if at risk;
More frequently if high risk
Covered at 100%
Cardiovascular Disease Screening Once every 5 years for all beneficiaries with no signs or symptoms Covered at 100%
Cardiovascular Disease Behavioral Therapy One CVD risk reduction visit annually Covered at 100%
Colorectal Cancer Screening: Screening Colonoscopy Normal risk: Once every 10 years 
High risk: Once every 2 years
Covered at 100%
Colorectal Cancer Screening: Fecal Occult Blood Test Every year Covered at 100%
Colorectal Cancer Screening: Flex Sigmoidoscopy Once every 4 years unless screening colonoscopy was performed less than 120 months prior Covered at 100%
Colorectal Cancer Screening: Barium Enema Once every 4 years if used instead of Flex sigmoidoscopy You pay 20% of the
Medicare-approved
amount; deductible
waived
Colorectal Cancer Screening: sDNA Test Once every 3 years Covered at 100%
Depression Screening Once per year Covered at 100%
Diabetes Screening One screening per year if not diagnosed pre-diabetic;
Twice per year if diagnosed pre-diabetic
Covered at 100%
Diabetes Self-Management Training Initial training: Up to 10 hours within a 12 month period
Subsequent years: Up to 2 hours within a 12 month period
You pay 20% of the
Medicare-approved
amount after
meeting the Part B
deductible
Flu Vaccine Once per influenza season Covered at 100%
Glaucoma Screening Once per year for those at risk You pay 20% of the 
Medicare-approved 
amount after 
meeting the Part B 
deductible
Hepatitis B Vaccine Three scheduled injections for those at medium or high risk Covered at 100%
Hepatitis C Screening Annually for those at high risk; or
Once in a lifetime for those born
between 1945 and 1965
Covered at 100%
HIV Screening Once per year for those at risk;
Three times per pregnancy for those who are pregnant
Covered at 100%
Initial Preventive Physical Exam (IPPE)
"Welcome to Medicare Exam"
Once for all new beneficiaries within 12 months of starting Part B Covered at 100%
Lung Cancer Screening Low-dose CT once per year for those who are high risk Covered at 100%
Mammogram Once for those aged 35-39;
Annually for those 40 and older
Covered at 100%
Medical Nutrition Therapy First year: 3 hours of counseling;
Subsequent years: 2 hours
*For those diagnosed with diabetes, renal disease, or have had a kidney transplant
Covered at 100%
Obesity Behavior Therapy For those with a BMI >30
First Month: one visit every week;
Months 2-6: one visit every other week;
Months 7-12: one visit every month
Covered at 100%
Pap Test and Pelvic Exam Annually for those at high risk;
Every 2 years for normal risk
Covered at 100%
Pneumonia Vaccine An initial vaccine and a second vaccine one year after the first was received Covered at 100%
Prostate Cancer Screening Annually for males 50+ PSA Covered at 100%;
DRE - You pay 20%
of Medicare
approved  amount
after meeting the
Part B  deductible
Sexually Transmitted Infection
Screening and Counseling
Annually for those at high risk;
More frequently if pregnant
Covered at 100%
Tobacco Use Cessation Counseling Two attempts per year (each attempt includes up to four counseling sessions) Covered at 100%

 

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