Original Medicare covers most preventive care in Georgia at $0 to you, with no deductible and no coinsurance, as long as your doctor or clinic accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services That $0 slate of Georgia Medicare preventive services spans two wellness visits, a set of cancer and chronic-disease screenings, and recommended vaccines.
The catch Georgia families keep running into is that a free screening can quietly become a billed service, and the rules that decide whether you owe anything work differently if you also have Georgia Medicaid or a Medicare Savings Program. This guide explains what is genuinely free, why a screening sometimes turns into a bill, and how being dually eligible for Medicare and Medicaid changes the math.
What "Free" Really Means for Georgia Medicare Preventive Services
For Georgia Medicare preventive services, the single word that decides your bill is "assignment." Medicare preventive services are covered at $0, with the Part B deductible waived and no coinsurance, but only when the provider accepts assignment, meaning they agree to take the Medicare-approved amount as full payment.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services Most Georgia primary care practices and hospital-based clinics accept assignment, but it is worth confirming at the front desk before the visit.
That $0 pricing is a real exception. For ordinary Part B services, a beneficiary generally owes 20% coinsurance after meeting the annual deductible, which is $283 in 2026.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles Preventive care is carved out of that rule precisely to remove the cost barrier to catching disease early.
Assignment also protects you from being overcharged. A provider who does not participate in Medicare and does not accept assignment can bill you up to the limiting charge, which is no more than 15% above the Medicare-approved amount (115% of the non-participating fee schedule).Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Does your provider accept Medicare as full payment?. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/basics/costs/medicare-costs/provider-accept-Medicare For a preventive visit you expected to be free, that is an unwelcome surprise, and it is avoidable by choosing a participating provider.
The Two Wellness Visits Georgians Confuse (and Why Neither Is a Physical)
The most common misunderstanding in this whole benefit is treating the "free wellness visit" as a free annual physical. It is not, and the distinction saves real money.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
- The Welcome to Medicare visit (formally the Initial Preventive Physical Examination, or IPPE) is a one-time visit available during the first 12 months you have Part B. It reviews your medical and family history, screens your risk factors, and builds a starter prevention plan.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
- The Annual Wellness Visit (AWV) is covered once every 12 months, but your first one cannot take place within 12 months of your Part B enrollment or of your Welcome to Medicare visit. It builds or updates a personalized prevention plan using a health risk assessment.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Both are $0 with assignment, and because your first AWV cannot fall within 12 months of the Welcome visit, you cannot have both inside the same 12-month span. The Welcome visit comes first.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Here is the part competitors state weakly or skip: Medicare does not cover a routine head-to-toe annual physical anywhere. The AWV is a planning and risk-review appointment, not a hands-on exam with bloodwork. If you show up expecting a full physical and ask for extra tests, those added services can be billed under normal Part B rules. Knowing this before the appointment is how you avoid the surprise.
Which Georgia Medicare Preventive Services Cost $0
Beyond the two visits, Part B covers a broad slate of screenings and vaccines at $0 when the provider accepts assignment. Georgia beneficiaries get the same Part B benefit as everyone else, because these are federal Medicare coverage rules rather than state ones. What does vary by state is the Medicaid and Medicare Savings Program help that picks up the costs Part B leaves behind, which the sections below cover.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
| Preventive service | Who and how often | Your cost with assignment |
|---|---|---|
| Welcome to Medicare visit (IPPE) | Once, in your first 12 months of Part B | $0 |
| Annual Wellness Visit (AWV) | Yearly; the first cannot fall within 12 months of your Part B enrollment or your Welcome visit | $0 |
| Screening mammogram | Women 40 and older, every 12 months, plus a one-time baseline mammogram for women 35 to 39 | $0 (a diagnostic mammogram is 20%) |
| Cervical and vaginal cancer screening (Pap test) | Every 24 months, or every 12 months if high-risk | $0 |
| Screening colonoscopy | Frequency varies by test and risk | $0 (15% if a polyp is removed) |
| Lung cancer low-dose CT (LDCT) | Once a year, ages 50 to 77, with a smoking history of at least 20 pack-years | $0 |
| Prostate cancer screening | Men over 50, once every 12 months | $0 for the PSA blood test (the digital rectal exam is 20%) |
| Recommended vaccines | Flu, pneumococcal, COVID-19, plus shingles and others | $0 |
The table above lists the most common $0 services rather than every one. Part B also covers bone mass measurement, a bone-density test, once every 24 months at no cost with assignment for beneficiaries who meet one of five risk conditions.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Bone mass measurements coverage. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/coverage/bone-mass-measurements Part B likewise covers a cardiovascular disease screening lipid panel once every 5 years at $0 with assignment for people who show no symptoms of heart disease,Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Cardiovascular disease screenings. medicare.gov. Retrieved Jul 10, 2026, from https://www.medicare.gov/coverage/cardiovascular-disease-screenings and hepatitis C screening at $0 for adults born between 1945 and 1965 and for those at higher risk, usually as a once-in-a-lifetime test.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Hepatitis C virus infection screenings. medicare.gov. Retrieved Jul 11, 2026, from https://www.medicare.gov/coverage/hepatitis-c-virus-infection-screenings One notable benefit runs the other way: glaucoma screening is covered once every 12 months for people at high risk, including African Americans age 50 and over, but it is not a $0 service, and you generally pay 20% of the Medicare-approved amount after meeting the annual Part B deductible.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings For the exact eligibility, frequency, and follow-up rules on any one of these, Brevy has a dedicated Georgia guide, linked under Learn More below. Two categories are worth calling out here.
Vaccines split between Part B and Part D, and most now cost nothing. Part B covers flu, pneumococcal, COVID-19, and hepatitis B vaccines at $0 with assignment (on any of three conditions, not risk alone). Every other Advisory Committee on Immunization Practices (ACIP) recommended vaccine, including the shingles (zoster), RSV, and Tdap vaccines, is covered under Part D, and since January 1, 2023, under the Inflation Reduction Act, those Part D vaccines carry $0 cost-sharing.Centers for Medicare & Medicaid Services. (n.d.). Flu Shots Coverage - Medicare. medicare.gov. Retrieved Jul 24, 2026, from https://www.medicare.gov/coverage/flu-shots Before 2023, a shingles shot could cost a Georgia beneficiary real money; the change is recent and often missed.
Cancer screenings are the heart of the $0 slate, covering mammograms, cervical and colorectal screening, lung LDCT for qualifying smokers, and the prostate PSA test.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services The important asterisks are the ones that create bills, which the next section walks through.
Why a "Free" Screening Can Turn Into a Bill
The $0 price attaches to the preventive service. The moment a screening turns into a diagnostic procedure, or a separate problem is handled in the same visit, normal Part B cost-sharing can apply to those added services, which in 2026 means the $283 deductible and 20% coinsurance.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles These bills are usually legitimate, not billing errors. Three everyday triggers cause almost all of them:
- A screening colonoscopy finds and removes a polyp. The removal makes the procedure diagnostic, and you pay 15% of the Medicare-approved amount for the doctor's services, with the Part B deductible waived. If it is done in a hospital outpatient department or an ambulatory surgical center, a separate 15% facility coinsurance applies on top of that. The 15% is a statutory phase-down: it drops to 10% for 2027 through 2029, and the rule sunsets for tests furnished on or after January 1, 2030, when these follow-up services go back to $0.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
- A screening mammogram leads to a diagnostic mammogram, or a PSA test is paired with a digital rectal exam. The screening test is $0, but the diagnostic mammogram and the rectal exam are billed at 20% after the deductible.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
- You raise a separate complaint during a wellness visit. The classic "while I'm here, my knee has been bothering me" turns into a separate, non-preventive service that carries the usual deductible and 20% coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
The takeaway is not to skip the screening or stay quiet about a real problem. It is to recognize such a charge as legitimate and to ask the provider, before the visit, whether anything is likely to be billed as diagnostic. For most Georgians those charges land on you or your Medigap plan. For dually eligible Georgians, they often do not, which is the next section.
How Georgia Dual Eligibles and Medicare Savings Program Members Are Protected
This is where Georgia matters most. If you have both Medicare and Georgia Medicaid, or you get help through a Medicare Savings Program, the diagnostic-conversion charges that worry other beneficiaries are often covered for you, and in some cases you cannot be billed for them at all.
People who have both Medicare and Medicaid are "dually eligible," in one of two groups: full-benefit duals, who have Medicare plus full Georgia Medicaid, and partial-benefit duals, who get help only through a Medicare Savings Program. Medicare pays first; Georgia Medicaid is the secondary payer and can cover Medicare premiums and cost-sharing.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf So when a screening colonoscopy converts to diagnostic and generates coinsurance on the diagnostic portion, a full-benefit dual's Medicaid can pick it up.
The strongest protection belongs to the Qualified Medicare Beneficiary (QMB) group. Federal law bars Medicare providers, suppliers, and pharmacies from billing a QMB individual for Medicare Part A and Part B deductibles, coinsurance, or copayments. A QMB has no legal obligation to pay that cost-sharing, and the ban binds every Original Medicare and Medicare Advantage provider and supplier, not only the ones that accept Medicaid.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf CMS reports that QMBs are still wrongly billed in practice, so a QMB member who receives a bill for the diagnostic portion of a "free" screening should not pay it and should contact GeorgiaCares or Palmetto GBA; a provider who improperly bills a QMB is subject to sanctions and has to recall the bill and refund anything already collected.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf Extra Help, the Part D Low-Income Subsidy, also arrives without a separate application for three groups: people with full-benefit Medicaid, people whose state pays their Part B premium through a Medicare Savings Program, and SSI recipients.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf
In Georgia, the Medicare Savings Programs are part of Georgia Medicaid, and you apply through your county Division of Family and Children Services (DFCS) office on form 700, or online at Georgia Gateway. An application for the Part D Low Income Subsidy filed with Social Security also counts as an MSP application. The 2026 federal monthly income and resource limits, which apply in every state except Alaska and Hawaii, are:
| Program | Monthly income limit (individual / couple) | What it pays | Federal resource limit (individual / couple) |
|---|---|---|---|
| QMB | $1,350 / $1,824 | Part B premiums, deductibles, coinsurance, and copayments, plus the Part A premium if you do not have premium-free Part A | $9,950 / $14,910 |
| SLMB | $1,616 / $2,184 | Part B premium only (you must have both Part A and Part B) | $9,950 / $14,910 |
| QI | $1,816 / $2,455 | Part B premium only; you must reapply every year | $9,950 / $14,910 |
One caution on the resource figures, because Georgia's own paperwork disagrees with them. The $9,950 and $14,910 limits above come from SSA and Medicare.gov, but Georgia Medicaid's Medicare Savings Programs FAQ still publishes an older, lower ceiling of $7,390 for one person and $11,090 for a married couple. Confirm the current figure with DFCS instead of assuming you are over it, and apply either way: Medicare.gov's own guidance is that you may still qualify in your state even if your income or resources run above the federal limits listed, and that you should apply even if you don't think you qualify. These limits go up each year.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Jul 30, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
Full-benefit duals can also enroll in a Dual Eligible Special Needs Plan (D-SNP), the Medicare Advantage plan type built for people who have both Medicare and Medicaid. Which D-SNPs are available differs from place to place, because insurers decide where they do business, so a plan offered in one Georgia county may not be sold in the next; check Medicare's Plan Finder or call GeorgiaCares rather than assume. The Georgia Department of Community Health announced that, to comply with the federal D-SNP integration requirements at 42 CFR 422.514(h), it would place a moratorium on contracting with any new D-SNPs starting August 1, 2025, with further updates to come once the future state has been redefined.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP
How to Keep Your Georgia Preventive Visit at $0
Confirm the provider accepts assignment
Ask the front desk before you book. Accepting assignment is what makes the preventive service $0, and it also caps what a non-participating provider could otherwise charge.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Say the visit is for the covered preventive service
Book it as a Welcome to Medicare visit, an Annual Wellness Visit, or the specific screening, so it is coded as preventive rather than a problem-focused office visit.
Ask in advance what could be billed as diagnostic
If your provider expects to remove a polyp, order a diagnostic mammogram, or address a separate complaint, ask what that would cost so no bill surprises you later.
If you are a dual eligible, tell them
Share your Medicaid or QMB status so the office bills Georgia Medicaid as the secondary payer. QMB members cannot be charged Medicare Part A or Part B cost-sharing at all.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf
Check any bill against your Medicare Summary Notice
If a service you expected to be $0 shows a charge, call the billing office first, then GeorgiaCares or Palmetto GBA if it is not resolved.
Where Georgia Beneficiaries Get Preventive Care
Most preventive services are delivered in primary care, and Georgia's major systems, including Emory Healthcare, Piedmont, Wellstar, Northeast Georgia, Memorial Health, Augusta University Health, Atrium Health Navicent, Phoebe Putney, and Grady, all run primary care networks alongside thousands of independent practices.
Georgia also has a statewide network of Federally Qualified Health Centers (FQHCs) that accept Medicare and deliver preventive care on a sliding-fee scale, which matters most in rural Georgia and underserved urban neighborhoods. To find one, use the federal Find a Health Center tool at findahealthcenter.hrsa.gov. County health departments across Georgia, run by the Georgia Department of Public Health, also provide immunizations, certain screenings, and women's health services.
Frequently Asked Questions
Does Medicare cover an annual physical in Georgia?
No. Medicare does not cover a routine head-to-toe annual physical. It covers the one-time Welcome to Medicare visit in your first 12 months of Part B and the yearly Annual Wellness Visit after that, both at $0 with assignment. Both are prevention-planning visits, not a full physical exam.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Are all Medicare preventive services really free?
Most are $0 when the provider accepts assignment, but there are exceptions. If a screening turns diagnostic (a polyp removed during a colonoscopy, or a diagnostic mammogram after an abnormal screening), or you add a separate complaint, the 2026 Part B deductible of $283 and 20% coinsurance can apply to those added services.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Why did I get a bill after a "free" colonoscopy?
Because a polyp was found and removed, which converts the screening to a diagnostic procedure. In 2026 you pay 15% of the Medicare-approved amount for the doctor's services, with the Part B deductible waived, plus a separate 15% facility coinsurance if it was done in a hospital outpatient department or an ambulatory surgical center. The rate drops to 10% for 2027 through 2029, and the rule sunsets for tests furnished on or after January 1, 2030, when these services go back to $0.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
I have Medicare and Georgia Medicaid. Do I owe anything for preventive care?
Usually not. Georgia Medicaid can cover Medicare cost-sharing as the secondary payer, and if you are in the QMB group, federal law prohibits providers from billing you for Medicare Part A and Part B deductibles, coinsurance, or copays at all. If you get such a bill, do not pay it and contact GeorgiaCares.Centers for Medicare & Medicaid Services. (n.d.). Beneficiaries dually eligible medicare medicaid. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/files/document/beneficiaries-dually-eligible-medicare-medicaid.pdf
How much can I earn and still get help paying Medicare costs in Georgia?
For 2026, the federal QMB monthly income limit is $1,350 for an individual and $1,824 for a couple, with higher limits for SLMB and QI, and a resource limit of $9,950 individual or $14,910 couple. Georgia Medicaid's own MSP FAQ still lists a lower resource ceiling of $7,390 for one person and $11,090 for a couple, so confirm the current figure with Georgia DFCS and apply even if you think you are over it. These limits go up each year.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Jul 30, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
Does Medicare cover the shingles shot in Georgia, and what does it cost?
Yes. The shingles vaccine is covered under Part D, and since January 1, 2023, under the Inflation Reduction Act, it and other ACIP-recommended Part D vaccines carry $0 cost-sharing. Flu, pneumococcal, and COVID-19 vaccines are covered at $0 under Part B.Centers for Medicare & Medicaid Services. (n.d.). Flu Shots Coverage - Medicare. medicare.gov. Retrieved Jul 24, 2026, from https://www.medicare.gov/coverage/flu-shots
Where to Get Help
Learn More
Find personalized help understanding your Georgia Medicare preventive services coverage at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.