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Does Medicare cover preventative services?

Preventive Services Covered By Medicare

Medicare is a national health insurance program for people ages 65+ and younger people with certain disabilities.

The 2011 Affordable Care Act expands the list of preventive care services you can get for free. Medicare recipients can now receive annual wellness visits to their doctor, flu shots and tests like prostate cancer screenings and mammograms.

When you become eligible for Medicare Part B (outpatient insurance), you can get a Welcome to Medicare Preventive Visit. Your doctor will review your medical history and plan your preventive care needs.

After this first consultation, you can see your doctor for an Annual Wellness Visit every year.

For most preventive care, you'll usually pay nothing out of pocket if you have original Medicare and see providers who accept assignments. "Accepting assignments" means that they accept Medicare's approved amount as full payment for a service. However, you may have to pay a deductible or coinsurance if your doctor has to do further tests or procedures.

Medicare completely covers certain other preventive care services for patients who have certain risk factors for disease. This applies to such services as diabetes screenings, bone mass measurements and testing for glaucoma.

There are new preventive care services offered by Medicare since the fall of 2011. New services include screenings for depression, misuse of alcohol and obesity. There is also dietary counseling for people who are overweight and a cardiovascular risk reduction visit for combating heart disease.

Starting in 2012, if you're in a Medicare Advantage plan, your plan can't charge you for preventive care services that are free for people with original Medicare. You are, however, required to see network providers within the plan.

You can learn more about Medicare's preventive services by visiting You can also call 1.800.MEDICARE (1.800.633.4227). TTY users should call 1.877.486.2048.

This FAQ was a story in Volume 28, Issue 1 of "The Alert" - a newsletter for seniors published by Legal Aid.   Click here to read the full issue.

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