A lot of Medicare's best value costs you nothing, and most people leave it on the table. Medicare covers most preventive services at $0 as long as your provider accepts assignment, no deductible and no coinsurance. That includes two wellness visits, a long list of screenings, and the recommended vaccines. This guide walks through what's actually free, which two visits people mix up, and the one billing trap that can turn a free screening into a bill.
What "free" actually means here
So here's the thing. When Medicare says a preventive service is covered at no cost, it means you pay nothing out of pocket for that service: no copay, no coinsurance, and the Part B deductible doesn't apply. That's a real deal, and it's different from how the rest of Part B works, where you usually owe 20% after meeting the deductible.
There's one condition attached to it, and it matters: your provider has to accept assignment. That means they agree to take the Medicare-approved amount as full payment. Most doctors who see Medicare patients do. If a provider doesn't accept assignment, you can get charged more, so it's worth a quick question to the front desk before the appointment.
The free pricing applies to the preventive service itself. Hold onto that word. It's the hinge for the billing trap we'll get to at the end.
The two visits people mix up
Medicare has two checkup-style visits, they sound almost identical, and almost nobody can tell them apart. Neither one is a head-to-toe physical exam, which surprises people who show up expecting bloodwork and a full once-over. Here's the difference at a glance, then the detail.
| Welcome to Medicare visit | Yearly Wellness visit | |
|---|---|---|
| How often | One time only | Once every 12 months |
| When you qualify | First 12 months of Part B | After more than 12 months on Part B |
| What it is | History review and a starter prevention plan | Health Risk Assessment and an updated prevention plan |
| Your cost | $0 with assignment | $0 with assignment |
| A physical? | No | No |
The Welcome to Medicare visit
The Welcome to Medicare visit (its formal name is the Initial Preventive Physical Examination) is a one-time visit you can get during your first 12 months with Part B. Use it or lose it, basically. Once that first year is up, the window closes.
It's a get-acquainted appointment. Your doctor reviews your medical and family history, checks your blood pressure, weight, and vision, talks through your risk factors, and helps you build a plan for staying healthy, including a schedule for the screenings and shots you'll want going forward. Think of it as setting the baseline, not running every test.
The yearly Wellness visit
The yearly Wellness visit (the Annual Wellness Visit) is the recurring one. You can get it once every 12 months, but only after you've had Part B for longer than 12 months. So you can't get it in your first year. That first year is the Welcome visit's territory.
The yearly visit centers on a Health Risk Assessment, a questionnaire about your health and habits that you and your doctor use to update your personalized prevention plan. You'll review your medications, screen for things like cognitive changes and depression risk, and adjust the schedule for upcoming screenings. Again, it's a planning and check-in visit, not a physical.
Screenings and vaccines that cost $0
Beyond the two visits, Part B covers a long list of screenings at no cost, again when the provider accepts assignment. These are the preventive tests recommended for catching problems early, before symptoms show up. The headline ones:
- Mammograms for breast cancer screening.
- Colorectal cancer screening, including several test types.
- Cardiovascular screening, the blood tests that check your cholesterol and risk of heart disease.
- Diabetes screening for people with certain risk factors.
- Depression screening, done in a primary care setting.
That's not the whole list. Medicare also covers things like bone density tests, certain cancer screenings, screenings for sexually transmitted infections, and counseling to help you quit smoking, all at $0. The full, current rundown lives on Medicare's preventive services page, which is the place to confirm whether a specific test is covered for your situation.
Vaccines are the other big free category. The flu shot, the COVID-19 vaccine, the pneumococcal (pneumonia) shots, and the hepatitis B vaccine have long been covered at no cost. And here's a more recent change worth knowing: the Inflation Reduction Act made the adult vaccines covered under Part D, like the shingles vaccine, free as well. Before that law, a shingles shot could run you real money out of pocket. Now it's $0.
The one billing trap, and how to avoid it
This is the part that trips people up, so read it before your next appointment. The $0 price applies to the preventive service. The moment a service stops being preventive and becomes diagnostic, the normal Part B rules kick back in: the $283 annual deductible and 20% coinsurance.
What does that look like in practice? Two common ways a free visit turns into a bill:
A screening turns diagnostic. Say you go in for a routine, free colorectal cancer screening, and during it the doctor finds and removes a polyp. That's no longer just screening, it's a procedure, and it can be billed under the diagnostic rules. The screening was free; the polyp removal may not be. This catches a lot of people off guard.
Extra services happen in the same visit. You're in for your free yearly Wellness visit, and you mention your knee's been bothering you. The doctor examines and treats the knee. That knee evaluation is a separate, non-preventive service, and it can carry the deductible and 20% coinsurance, even though the wellness visit itself stayed free.
None of this means you should skip the screening or stay quiet about your knee. It just means a charge isn't always a billing error. If you want to avoid surprises, two things help: ask your provider whether anything in the visit will be billed as diagnostic, and confirm they accept assignment. For a sense of what those normal Part B costs look like across the board, the Medicare basics guide breaks down the 2026 deductible and coinsurance figures.
Frequently asked questions
Yes, when your provider accepts assignment. Both the one-time Welcome to Medicare visit and the recurring yearly Wellness visit are covered at $0, with no deductible and no coinsurance. The catch is if extra, non-preventive services happen during the same appointment, those added services can be billed under the normal Part B rules.
No, and this surprises a lot of people. Neither the Welcome to Medicare visit nor the yearly Wellness visit is a head-to-toe physical. They're planning and risk-review appointments: your doctor reviews your history, checks a few basics, and builds or updates a prevention plan. If you want a full physical, that's a separate service and Medicare may not cover it the same way.
Timing, mostly. The Welcome to Medicare visit is a one-time appointment available only in your first 12 months of Part B. The yearly Wellness visit is recurring, once every 12 months, and you can only get it after you've had Part B for more than 12 months. So you can't get both in the same year, and the Welcome visit comes first.
The most common reason is that the screening turned diagnostic. If a routine colonoscopy finds and removes a polyp, for example, the removal can be billed under the Part B deductible and 20% coinsurance even though the screening part was free. A separate problem you raise during a wellness visit can also be billed. It's often not an error.
Yes. Medicare Advantage plans must cover everything Original Medicare covers, including these preventive services at no cost when you follow the plan's rules and use in-network providers. The same diagnostic-versus-screening logic applies, so the billing trap exists there too.
Learn More
- What Is Medicare? Parts A, B, C, and D explained
- How Medicare Part D drug coverage works
- What Medicare covers for skilled nursing, home health, and hospice
- Medicare and advance care planning
Find personalized help figuring out which Medicare preventive services you're owed at no cost 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.