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, 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 Medicare preventive services actually cost
Here is the short answer: when Medicare says a preventive service is covered at no cost, you pay nothing out of pocket for that service. No copay, no coinsurance, and the Part B deductible does not apply.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 is different from how the rest of Part B works, where you usually owe 20% of the Medicare-approved amount after you meet the deductible.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
There is one condition attached, 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 does not accept assignment, you can be charged more, so it is worth a quick question to the front desk before the appointment.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 free pricing applies to the preventive service itself. Hold onto that word. It is the hinge for the billing trap we will get to at the end.
The two wellness 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. In fact, Medicare does not cover a routine annual physical at all, so these two planning visits are the closest thing to one that the program pays for.Centers for Medicare & Medicaid Services. (n.d.). Yearly "Wellness" visits. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/yearly-wellness-visits Here is the difference at a glance, then the detail.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
| 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, or IPPE) 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 costs $0 when your provider accepts assignment, and the Part B deductible is waived.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
It is 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 will want going forward. Think of it as setting the baseline, not running every test.
The yearly Wellness visit
The yearly Annual Wellness Visit (AWV) is the recurring one. You can get it once every 12 months, but only after you have had Part B for longer than 12 months. So you cannot get it in your first year. That first year is the Welcome visit's territory. It is also $0 with assignment. If you never had the Welcome visit, you still qualify for the yearly Wellness visit: Medicare states you do not need to have had a "Welcome to Medicare" preventive visit to get one.Centers for Medicare & Medicaid Services. (n.d.). Yearly "Wellness" visits. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/yearly-wellness-visits,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 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 will review your medications, screen for things like cognitive changes and depression risk, and adjust the schedule for upcoming screenings. Again, it is a planning and check-in visit, not a physical.
Medicare preventive services that cost $0: screenings and vaccines
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: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
- Mammograms for breast cancer screening, at $0 once every 12 months for women 40 and older, plus a one-time baseline. (A diagnostic mammogram is different: you pay 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
- Colorectal cancer screening, including screening colonoscopy (there is no minimum age, and it is covered once every 24 months if you are at high risk for colorectal cancer, otherwise once every 120 months, or 48 months after a previous flexible sigmoidoscopy) and flexible sigmoidoscopy at 45 or older.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
- Cardiovascular screening, the blood tests that check your cholesterol and risk of heart disease.
- Cervical and vaginal cancer screening (a Pap test once every 24 months in most cases, or every 12 months if you are at high risk for cervical or vaginal cancer, or of child-bearing age and had an abnormal Pap test in the past 36 months).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
- Lung cancer screening with a low-dose CT scan, once a year, but only if you meet all five of Medicare's conditions: you are between 50 and 77, you have no signs or symptoms of lung cancer, you are a current smoker or quit within the last 15 years, you have a tobacco smoking history of at least 20 pack years, and you get an order from your health care provider. Before the first screening you also have to schedule an appointment with your provider to discuss the benefits and risks.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
- Prostate cancer screening: the PSA blood test is $0 (the separate digital rectal exam costs 20% after the deductible).
- Diabetes and depression screening for people who qualify.
High risk is broader than it sounds
Two of those screenings hand you a shorter interval if you are "at high risk," and that phrase costs people screenings they were entitled to. It sounds like it means a personal cancer history. It does not. In both cases it is a defined term in federal regulation, and the definitions are lists of routes in, not tests you have to pass.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
For colorectal cancer, you count as at high risk if any one of six things is true: a close relative (sibling, parent, or child) who has had colorectal cancer or an adenomatous polyp; a family history of familial adenomatous polyposis; a family history of hereditary nonpolyposis colorectal cancer; a personal history of adenomatous polyps; a personal history of colorectal cancer; or inflammatory bowel disease, including Crohn's Disease and ulcerative colitis. Any one is enough on its own. A parent's polyp qualifies you even if you have never had cancer yourself. That moves you from the 120-month colonoscopy schedule to the 24-month one, and payment can be made once at least 23 months have passed since the month of your last screening colonoscopy.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
For cervical and vaginal cancer, the regulation that governs how often Medicare pays for the screening pelvic examination lists the high-risk factors as early onset of sexual activity (under 16), five or more sexual partners in a lifetime, a history of a sexually transmitted disease including HIV infection, and the absence of three negative or any Pap smears within the previous 7 years, plus, for vaginal cancer, being a DES-exposed daughter of a woman who took DES during pregnancy. Read that fourth one again, because it catches more women than the others combined: if you simply stopped being screened, you meet it, and you are on the 12-month schedule rather than the 24-month one.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 is not the whole list. Medicare also covers things like bone density tests, 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.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
Vaccines are the other big free category. Part B covers the flu shot, the COVID-19 vaccine, and the pneumococcal (pneumonia) shots for anyone with Medicare, and you pay nothing when your provider accepts assignment. It also covers the hepatitis B vaccine on the same terms, but here you have to meet at least one of three conditions: you have never gotten a complete series of hepatitis B shots, you do not know your vaccination history, or you have a health condition or situation that puts you at medium or high risk (diabetes, end-stage renal disease, or living with someone who has hepatitis 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 And here is 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 is $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,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
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 can kick back in: the $283 annual deductible and 20% coinsurance on a service Medicare covers.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 And if Medicare does not cover the added test or service at all, like a routine physical exam, your exposure is not capped at 20%. Medicare's own warning on both wellness visit pages is that you may have to pay the full amount.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
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 screening colonoscopy, and during it the doctor finds and removes a polyp. That is no longer just screening, it is a procedure. Under a special Medicare rule, you pay 15% of the Medicare-approved amount for the provider's services in 2026 (the deductible is waived), and that share is scheduled to fall to 10% for 2027 through 2029 and to $0 in 2030. The screening was free; the polyp removal is not. This catches a lot of people off guard.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
Extra services happen in the same visit. You are in for your free yearly Wellness visit, and you mention your knee has 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.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,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
None of this means you should skip the screening or stay quiet about your knee. It just means a charge is not 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
Is the Medicare wellness visit free?
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 that if extra, non-preventive services happen during the same appointment, those added services can be billed under the normal Part B rules.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
Is the Medicare wellness visit a physical exam?
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, and Medicare does not cover a routine annual physical at all. They are planning and risk-review appointments: your doctor reviews your history, checks a few basics, and builds or updates a 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,Centers for Medicare & Medicaid Services. (n.d.). Yearly "Wellness" visits. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/yearly-wellness-visits
What's the difference between the Welcome to Medicare visit and the yearly Wellness visit?
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 have had Part B for more than 12 months. So you cannot get both in the same year, and 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
Why did I get a bill after a "free" screening?
The most common reason is that the screening turned diagnostic. If a screening colonoscopy finds and removes a polyp, for example, you pay 15% of the Medicare-approved amount for that removal in 2026, even though the screening part was free. A separate problem you raise during a wellness visit can also be billed under the Part B deductible and 20% coinsurance. It is often not an error.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,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
Do Medicare Advantage plans cover the same free preventive services?
Yes. Medicare Advantage (Part C) 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.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
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