Free Medicare Preventive Screenings in 2026: The Full List, Who Qualifies and How to Avoid Surprise Bills
Medicare covers a long list of preventive services, from mammograms and colon cancer tests to the yearly wellness visit and most vaccines, and most of them cost you nothing when your provider accepts Medicare assignment. No deductible, no 20% coinsurance.
The catch is in the details. Each screening has its own age range and schedule, a couple aren’t actually free, and a screening can turn into a billed “diagnostic” test if your doctor finds or treats something. This guide covers the full list and how to avoid surprise bills.
I’m a researcher who reads Medicare’s rules closely, not a doctor or licensed agent. The list follows Medicare’s official Guide to Medicare Preventive Services and its coverage pages, checked October 1, 2026. Medicare Advantage plans must cover the same preventive services, also at $0 in network.
Checkups: Welcome to Medicare and the Annual Wellness Visit
Welcome to Medicare preventive visit. Once, within your first 12 months of Part B. It covers your medical and family history, blood pressure, weight, a vision test, a medication review, and a schedule of the screenings you need.
Annual Wellness Visit. Every 12 months after your first year of Part B. It’s a planning visit, not a head-to-toe physical. It includes a health risk questionnaire, a memory check, depression screening, fall-risk review, a medication review and a personalized screening schedule. Medicare doesn’t cover a routine “annual physical.” Ask for the Annual Wellness Visit by name. See Annual Wellness Visit vs. a physical.
Cancer screenings
Breast cancer. A screening mammogram every 12 months for women 40 and older, $0. Women 35 to 39 can get one baseline mammogram. Diagnostic mammograms, done because of a lump or an abnormal result, cost 20% after the deductible. See Medicare mammogram coverage.
Colorectal cancer. Medicare covers several options, starting at 45 for most:
- Screening colonoscopy: every 10 years at average risk, every 2 years at high risk. No minimum age.
- Stool DNA test (like Cologuard) or blood-based test: every 3 years, ages 45 to 85, average risk, no symptoms.
- Stool test (FIT or FOBT): every 12 months, 45 and older.
- CT colonography (virtual colonoscopy): every 5 years at average risk, every 2 at high risk. Covered as screening since 2025.
- Flexible sigmoidoscopy: every 4 years.
If a stool or blood test comes back positive, the follow-up colonoscopy is covered as a screening, so it’s $0 too. If a polyp is removed during a screening colonoscopy, you pay 15% of the doctor’s charge in 2026, plus 15% to the facility, with no deductible. That share drops to 10% in 2027 and to zero in 2030. See colorectal cancer screening and Medicare colonoscopy coverage.
Lung cancer. A yearly low-dose CT scan if you’re 50 to 77, have no symptoms, have smoked at least 20 pack-years, and still smoke or quit within the last 15 years. You need a counseling visit with your provider before the first scan. See lung cancer screening.
Prostate cancer. A PSA blood test every 12 months for men over 50, $0. The digital rectal exam costs 20% after the deductible. See prostate cancer screening.
Cervical and vaginal cancer. A Pap test and pelvic exam every 24 months, or every 12 months if you’re at high risk. An HPV test with the Pap test is covered every 5 years for women 30 to 65.
Heart, diabetes, bone and other screenings
- Cardiovascular blood tests (cholesterol, lipids, triglycerides): every 5 years.
- Cardiovascular behavioral therapy: one visit a year with your primary care provider to lower heart risk.
- Diabetes screening: up to two a year if you have a risk factor such as high blood pressure, abnormal cholesterol, obesity or past high blood sugar, or two of: age 65 or older, overweight, family history, or past gestational diabetes.
- Bone density (DEXA): every 24 months if you’re at risk of osteoporosis, more often if medically necessary.
- Abdominal aortic aneurysm ultrasound: once, with a referral, for men 65 to 75 who’ve smoked at least 100 cigarettes, or anyone with a family history.
- Depression screening: once a year in primary care.
- Alcohol misuse screening: once a year, plus up to four counseling sessions if needed.
- Hepatitis C screening: once if you were born between 1945 and 1965 or had a transfusion before 1992; yearly for ongoing high risk.
- Hepatitis B and HIV screening: for people at risk, on set schedules.
- Obesity counseling: if your BMI is 30 or more, a series of visits with your primary care provider.
- Tobacco cessation counseling: up to 8 sessions a year.
- Medical nutrition therapy: if you have diabetes or kidney disease.
Not free: glaucoma testing. Medicare covers a yearly glaucoma test if you’re at high risk (diabetes, a family history of glaucoma, Black and 50 or older, or Hispanic and 65 or older), but you pay 20% after the deductible.
Vaccines
- Part B, $0: flu shot each season, COVID-19 vaccines, pneumococcal (pneumonia) vaccines, and hepatitis B vaccines for people at medium or high risk.
- Part D, $0: shingles (Shingrix), RSV and Tdap, and other vaccines recommended for adults, with no deductible or copay at an in-network pharmacy.
See flu vaccine for seniors, pneumonia vaccine, RSV vaccine and shingles vaccine.
How a free screening turns into a bill, and how to prevent it
- The provider doesn’t accept assignment. Ask when you book: “Do you accept Medicare assignment?”
- The visit includes treatment. If you bring up your knee pain during the Annual Wellness Visit and the doctor examines and treats it, that part is billed as a regular visit, with the deductible and 20%. Either accept that or book a separate visit.
- Screening becomes diagnostic. If you have symptoms, the test is diagnostic and isn’t free. A polyp removed during a colonoscopy costs 15% in 2026.
- Too soon. Medicare counts months exactly. A mammogram 11 months after the last one won’t be covered as a screening. Check your dates.
- Extra tests ordered “while we’re at it.” Blood tests outside the preventive list, like a vitamin D level, are billed normally. See Medicare blood test coverage.
If you’re charged for something that should have been free, call the provider’s billing office and ask them to check the billing codes. If that doesn’t fix it, you can appeal. See how to win a Medicare appeal.
How to keep track
- Log in to your Medicare account at Medicare.gov to see which preventive services you’ve had and when you’re due.
- Bring a list to your Annual Wellness Visit and ask for a written screening schedule.
- Book the flu shot and any other vaccines in early fall.
FAQ
Are all Medicare preventive screenings free?
Most are $0 when your provider accepts assignment. Exceptions include glaucoma tests and digital rectal exams (20% after the deductible) and polyp removal during a screening colonoscopy (15% in 2026).
Does Medicare cover an annual physical?
No. It covers the Welcome to Medicare visit and a yearly Annual Wellness Visit, which focus on prevention planning rather than a full physical exam.
At what age does Medicare stop covering colon cancer screening?
Stool DNA and blood-based tests are covered up to 85. Colonoscopy has no upper age limit in Medicare’s rules, though guidelines suggest deciding individually after 75.
Does Medicare Advantage cover the same screenings?
Yes. Plans must cover all Medicare preventive services, at no cost in network.
Are vaccines free under Medicare?
Yes. Flu, COVID-19, pneumonia and hepatitis B shots are $0 under Part B. Shingles, RSV, Tdap and other recommended adult vaccines are $0 under Part D.
Related guides
Skin Cancer in Seniors: Warning Signs, the ABCDEs, Prevention and What Medicare Covers
Pneumonia Vaccine for Seniors: Which Shot You Need After 50, and What Medicare Pays
