12 Things That Are Free Under Medicare

While most services come with a cost, some preventive screenings, vaccines and counseling are covered without charge

Dena Bunis,

AARP

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En español

Published October 27, 2023

/ Updated October 29, 2024

AARP

In this story

A few rules • Baseline check-in • Annual wellness checkup • Loads of vaccines • Alcohol counseling • Colon cancer tests • Depression screening • Diabetes tests • Lung cancer scan • Mammograms • Nutrition counseling • Prostate cancer tests • Smoking counseling

What Medicare beneficiaries must for pay out of pocket, such as monthly premiums, annual deductibles, and copayments for doctor visits and prescription drugs can be a big worry. But many enrollees may not realize is that some services won’t cost them a cent.

You can get vaccines and screenings for a number of illnesses and see your doctor each year for a wellness visit. You also can get counseling to help you kick smoking or manage your diabetes.

You won’t be subject to any out-of-pocket charges for these services as long as you use a health care provider who participates in Medicare, or if you get your health care through a Medicare Advantage plan, an in-network medical professional.

Here’s a look at a dozen things you can get for free from Medicare. For a full list of the program’s preventive and screening services, go to Medicare.gov.

1. A onetime Welcome to Medicare checkup in your first year

This visit must be made within the first 12 months of signing up for Medicare Part B, the part of Medicare that covers doctor visits and other outpatient services.

Think of this initial visit as a baseline check-in. Your provider will review your medical and personal history; see what medications you are taking; give you a flu and pneumococcal shot; monitor your vital signs including blood pressure, height and weight; do a simple vision test; ask some mental and behavioral health questions; and offer to help you create any advance directives you might not yet have.

All this will be free.

But after this general check-in if your doctor wants to order some diagnostic tests or perform some other services, the rules governing Part B will apply and you’ll be responsible for 20 percent of the costs. Your coinsurance or copay may be different if you are enrolled in a Medicare Advantage plan or if you have supplemental, or Medigap, insurance.

2. A wellness visit every year after that helps keep you healthy

The first thing to know about this is what it isn’t: a physical. This is a once-a-year visit to “update your personalized plan to help prevent disease or disability,” according to Medicare.

Your doctor will probably take your vital signs and review your medical history and medications. Providers are also expected to do a cognitive assessment to look for any signs of dementia.

If during this visit your doctor needs to order some tests, such as blood work or an actual physical exam, then as with that first welcome Medicare visit, the rules governing your coinsurance under Medicare Part B will apply.

3. Vaccines are meant to prevent many severe illnesses

Thanks to a federal law passed in 2022, Medicare now covers most vaccines at no cost to enrollees who have Medicare Part D prescription plans or Medicare Advantage drug coverage.

This includes inoculations such as the shots for shingles and RSV that the Centers for Disease Control and Prevention (CDC) recommends. Medicare Part B already had covered other vaccines, such as seasonal flu and COVID-19 shots, at no charge.

Quiz: Test your vaccine smarts

4. Alcohol counseling points out why age, alcohol don't mix

Medicare will cover one alcohol misuse screening each year.

In addition, the program will cover up to four brief face-to-face counseling sessions each year if you are someone who uses alcohol but doesn’t meet the medical criteria for being alcohol dependent. You must get the counseling in a primary care setting, such as a doctor’s office or clinic.

Quiz: Alcohol and your health

5. Colorectal screenings catch possible cancer early

Four separate screening tests for colorectal cancer are covered for free:

A fecal occult blood test every 12 months, starting at age 45. This will detect blood in the stool.

A flexible sigmoidoscopy every 48 months, also starting at age 45, with the proviso that you haven’t had a colonoscopy in the past 10 years.

A stool DNA test every three years for people 45 to 85 who are not at high risk for colon cancer and don’t have symptoms of colorectal disease.

A screening colonoscopy every 10 years if you are not at high risk for colon cancer, or every two years if you have a history of colon problems or a family history of colon cancer.

6. Depression screening can help combat isolation

Medicare covers one depression screening a year that must happen in a primary care setting, like a doctor’s office. Suicide rates among older men increase with age.

If a provider recommends follow-up treatment or other mental health and behavioral services, then the coinsurance rules under Part B would apply. In a crisis, people can contact the free and confidential Suicide & Crisis Lifeline by calling or texting 988 at any time.

7. Diabetes screenings can stop prediabetes from progressing

Medicare Part B will cover up to two diabetes screenings each year, including blood glucose tests, if your doctor determines you are at risk for developing diabetes and you have risk factors such as high blood pressure, a history of abnormal cholesterol levels, are obese or have a history of high blood sugar.

Part B will also cover these screenings if two or more of the following conditions apply:

You are 65 or older.
You’re overweight.
You have a family history of diabetes.
Or you’ve had diabetes while you were pregnant, often called gestational diabetes.

Quiz: How much do you know about prediabetes?

8. Lung cancer screenings are meant for smokers, ex-smokers

Medicare will cover a lung cancer screening using low-dose computed tomography, a special kind of X-ray, once a year if all these conditions apply:

You’re age 50 to 77.
You have no signs or symptoms of lung cancer.
You either smoke now or quit smoking in the past 15 years.
You have a history of smoking one pack a day for a 20-year period.
You get an order from your doctor or other health care provider.

9. Mammograms can discover breast cancer in early stages

Medicare will pay for a screening mammogram every 12 months if you are a woman age 40 or older. About a quarter of women ages 50 to 74 are not up to date on routine mammograms, the CDC says.

Be advised that if you get a diagnostic mammogram, which a doctor typically will order after a screening mammogram shows some suspicious results and they want to take a closer look, then the rules governing Part B will apply and you will be responsible for 20 percent of the cost.

That would also apply if a doctor orders a breast ultrasound because the Medicare enrollee has dense breasts. Medicare will cover diagnostic mammograms more often than once a year if a doctor says they are medically necessary.

10. Nutrition therapy helps you thrive with chronic conditions

Medicare will cover some nutrition services if you have diabetes or kidney disease or received a kidney transplant in the past 36 months. These services can include an initial nutrition and lifestyle assessment, individual or group sessions, help managing the lifestyle factors that affect your diabetes, and follow-up visits to check on your progress.

Quiz: How healthy are your cooking and eating habits?

11. Prostate cancer tests allow comparisons through the years

Staring the day after a man turns 50, Medicare will cover a prostate specific antigen (PSA) blood test every 12 months. If you also need a digital rectal exam or other follow-up services, then the 20 percent coinsurance rules for Medicare Part B will apply.

12. Smoking counseling’s goal is to get you to quit

Medicare will pay for up to eight counseling sessions over a 12-month period to help you stop smoking or using tobacco. Not only is smoking the cause of most lung cancers, is linked to high blood pressure, which is a risk for heart attacks and strokes.

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This story, originally published Oct. 27, 2023, was updated with new information and additional links.

Dena Bunis covered Medicare, health care, health policy and Congress. She also wrote the “Medicare Made Easy” column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.