The Preventive Care Medicare Already Covers
Most conversations about Medicare are about what it does not pay for. This one is about a long list of services it pays for entirely — screenings, vaccines and an annual visit, with no deductible and no coinsurance. Take-up is low, largely because people do not know the list exists, and it is the cheapest care available to anyone on Medicare.
- No cost when covered:: Most preventive services carry no deductible and no coinsurance if the provider accepts assignment.
- An annual wellness visit:: A yearly planning visit distinct from a physical examination.
- Frequency limits apply:: Each service has its own interval, and using one early can make it billable.
- Diagnostic changes the billing:: A screening that finds something and leads to a procedure can attract coinsurance.
Where the AI summary above gets this wrong
"Medicare covers an annual physical examination."
That's surface-true. Here's what it misses:
- The annual wellness visit is not a physical — It is a planning appointment: a review of medical history, medications, risk factors and a personalised prevention schedule. A routine physical examination is a different service and is generally not covered. People book one expecting the other and are disappointed by a visit that was working exactly as designed.
- A screening can become a billable procedure mid-appointment — A screening colonoscopy that finds and removes a polyp can change its billing character, and a preventive visit in which a new problem is discussed can generate a separate charge. Asking beforehand how the visit will be coded is a reasonable question and it prevents a surprising bill.
- Frequency rules are specific and easy to break — Each covered service has its own interval, and having one earlier than the schedule allows can shift the whole cost to the patient. The dates matter, and the provider's office is usually able to check them before the appointment rather than after.
01 What is covered without cost sharing
The list is long and specific. Cardiovascular disease screening, diabetes screening, several cancer screenings, bone density measurement, depression screening, and a range of vaccines including influenza, pneumococcal and hepatitis B.
There is also a one-off welcome visit in the first year of Part B, and an annual wellness visit thereafter. Both are planning appointments — reviewing history, medications and risk factors, and producing a personalised prevention schedule.
Cost sharing does not apply where the service is covered and the provider accepts assignment. That last condition matters: a provider who does not accept assignment can charge more, which is worth confirming when booking alongside the wider Medicare arrangements.
02 Where a bill can still arrive
The most common surprise is a preventive visit that turns diagnostic. If you raise a new symptom during a wellness visit and the doctor investigates it, that part of the appointment is a diagnostic service with its own cost sharing.
The same happens in procedures. A screening test that finds something and leads to treatment in the same session can change how the whole episode is billed, which is a well-known feature rather than an error, and one worth knowing about beforehand.
Frequency limits are the other source. Each service has an interval, and one taken early is generally not covered at all. Confirming eligibility dates with the provider's office before the appointment takes a minute and avoids a bill that is difficult to dispute afterwards.
Source: Medicare costs
03 Using what is available
The practical step is to book the annual wellness visit and to treat it as the appointment where the year's prevention is planned. The personalised schedule it produces is the list of what you are eligible for and when.
Bring the medication list, including anything bought over the counter, and the names of every other clinician involved. The value of the visit is largely in the review, and it is only as good as what is brought to it.
Then use the schedule. These services are already funded through the Part B premium, so declining them is not a saving. For a household already weighing the cost of that premium, using what it buys is the most straightforward way to get value from it.
Shows: the value of covered preventive services that go unused in a year, priced at what they would cost privately. Ignores: whether each service is clinically appropriate for you, the frequency limits that apply to each, and the coinsurance that arises when a screening leads to diagnostic work.
Source: What Medicare covers
This is the only part of Medicare where the advice is simply to use more of it. The services are paid for through a premium you are already paying, take-up is poor, and the annual wellness visit in particular is worth booking because it produces the list of everything else you are entitled to. One appointment a year, and the only thing to watch is that raising a new problem during it turns part of the visit into a billable one.
FAQ
Does Medicare cover an annual physical?
Not a routine physical examination. It covers a one-off welcome visit in the first year of Part B and an annual wellness visit thereafter, both of which are planning appointments rather than examinations.
Why did I get a bill for a preventive visit?
Usually because part of it became diagnostic — a new symptom was discussed and investigated — or because a frequency limit had not yet been met. Both change how the service is billed.
Do I pay anything for covered screenings?
Generally nothing, where the service is covered and the provider accepts assignment. Confirming that when booking is worth doing.
Sources
Regulator references
- Preventive and screening services · Centers for Medicare & Medicaid Services · 2026Which preventive services are covered and at what frequency.Last verified: 2026-09-07
- What Medicare covers · Centers for Medicare & Medicaid Services · 2026The scope these services sit within.Last verified: 2026-09-07
- Medicare costs · Centers for Medicare & Medicaid Services · 2026The coinsurance that applies when a preventive visit becomes diagnostic.Last verified: 2026-09-07
Calculator unit tests · the assertions this page's worked example is checked against, and their last result
Changelog
- 2026-09-07 — initial publish (new format)
Run this rule against your situation
See what this rule does to your own projection — month by month, to age 90.
Join the Waitlist
Jordan Reeves
Founder of Talk Through Wealth. A software engineer for over a decade before turning to retirement planning, Jordan built the projection engine after watching family members get fragmented, country-by-country advice that never reconciled. He writes about retirement the way the engine computes it: month-by-month, lifetime-long, and skeptical of any rule of thumb that hasn't been run through the math.