Medicare and preventive services — the free screenings worth knowing about

This article is for educational purposes only and does not constitute medical, legal, or financial advice. Every family situation is different, and you should consult with appropriate professionals about your specific circumstances.

Your mother mentions in passing that her knees hurt. Your father says he's "fine, just tired." You nod, move on, because there's always something. The bills are piling up, your work is demanding, and the idea of adding another doctor's appointment to the mix feels like one more impossible thing. So preventive care slides down the priority list, especially when it comes with a copay you're already worried about affording.

Here's what almost nobody knows: Medicare covers a whole range of preventive services at zero cost. Not ninety percent. Not eighty-five percent. Zero. No deductible, no copay, nothing. Your parent's annual wellness visit is free. Cancer screenings are free. Cognitive testing is free. Vaccines are free. These aren't perks or extras. They're part of the benefit that's already paid for.

The problem isn't access. The problem is that nobody ever says this out loud in a way that sticks. Your parent doesn't bring it up because they assume preventive care is something they can't afford. You don't prioritize it because you don't realize what Medicare actually covers. And somewhere in the shuffle, early detection gets pushed aside for the crisis that could have been prevented.

This matters more than it seems. I know this from watching families manage health issues that arrived without warning, that probably arrived with subtle warning signs that went unnoticed. And I know it from hearing, over and over, from adult children wishing they'd insisted their parent get that screening done when there was still time to catch something small.

What Preventive Services Medicare Covers at 100%

When your parent turns 65 and enrolls in Medicare, one of the most underused benefits is the annual wellness visit. This is not the same as a regular doctor's visit. This visit is specifically designed for prevention and early detection, and Medicare pays the full cost if you see your parent's regular doctor. The visit includes a comprehensive health assessment, a review of medical history, and discussion of goals. The doctor checks blood pressure, takes a full medication list, screens for depression, and assesses cognitive function. It typically takes 30 to 45 minutes. Your parent should bring a list of current medications and any supplements they're taking, even if they think they've mentioned them before.

During this wellness visit, the doctor can order preventive screenings based on your parent's age, health status, and risk factors. These screenings are covered at 100% when ordered during the wellness visit or when medically appropriate. For someone over 65, this might mean starting baseline heart and lung screenings if they haven't had recent ones. It might mean checking kidney function or bone density. The doctor decides what makes sense based on your parent's individual situation.

Immunizations are another category covered completely. Your parent needs a flu vaccine every year. Shingrix, the shingles vaccine, has become available recently and is remarkably effective at preventing shingles and the severe pain that can follow. This vaccine requires two doses given two to six months apart, and Medicare covers both completely. If your parent is 60 or older, they're eligible. Many people over 65 didn't get this vaccine when it first came out because they assumed they'd missed the window. They haven't. The vaccine is new enough that most people who need it haven't had it yet.

Pneumonia vaccines are covered, and the current recommendations have changed in recent years. Your parent might think they had their pneumococcal vaccine years ago and don't need another. That's not necessarily true anymore. The CDC updated pneumococcal vaccine recommendations for older adults, and if your parent hasn't had the newer vaccines, they need them. The beauty of mentioning this to your parent's doctor is that the doctor will know what your parent has had and what they still need.

RSV, or respiratory syncytial virus, is something people usually associate with babies. But RSV can be serious in older adults, and a new vaccine became available that Medicare covers completely. If your parent is over 60, they can get this vaccine once, and it helps protect them from a virus that can cause severe respiratory illness.

Cancer Screenings: What Your Parent Should Know About

Colorectal cancer screening starts at 50, and Medicare covers it completely. Your parent has options for how the screening happens. A colonoscopy is the most common, where a doctor looks at the entire colon. But there are other options like flexible sigmoidoscopy or a fecal immunochemical test. If your parent is squeamish about colonoscopy, they should mention that to their doctor because other options exist. The screening is covered. The sedation for the procedure is covered. The removal of polyps if they're found is covered. Your parent should have this screening done, and they should ask their doctor what kind of screening makes most sense for their situation.

Mammograms are covered every one to two years for women 40 and older. If your mother is getting older, she might wonder if mammograms are still necessary. The answer varies based on her overall health and prior results, but the screening itself is free, and having it done regularly catches breast cancer early when treatment is most effective. 3D mammography, which is slightly better at detecting early cancers, is also covered. If your mother has had previous mammograms, her doctor will know whether more frequent screening makes sense.

Prostate cancer screening is more complicated, and your father should talk to his doctor about whether screening makes sense for him. Medicare covers the PSA test and digital rectal exam, but the medical community has debates about screening benefits and risks. The important part is that if your father wants the screening, it's covered. He shouldn't avoid getting it because he thinks he can't afford it. But he should have a conversation with his doctor about whether the screening is the right choice for him specifically.

Lung cancer screening is covered for people 50 to 80 who have a significant smoking history. If your parent was a smoker or is a current smoker, this screening could catch cancer at an early, treatable stage. Medicare covers the low-dose CT scan that's used for screening. If your parent smoked for 30 pack-years or more (which sounds complicated but just means the number of cigarettes per day multiplied by the years they smoked), they qualify. This screening happens at specialized centers, and the person doing it will discuss the results with your parent and their doctor.

Skin cancer screening is available during the annual wellness visit. Your parent's doctor can check their skin for suspicious spots, which is good because skin cancer is common and very treatable when caught early. If your parent has a lot of moles or has had previous skin cancer, they might benefit from yearly screening. If the doctor finds something that needs a biopsy, that's covered too.

Cardiovascular Screening and Testing

Heart disease is the leading cause of death in the United States, and preventive screening can make a real difference. During the annual wellness visit, your parent's blood pressure is checked. Elevated blood pressure is a risk factor for heart disease and stroke, and catching it early matters. If the result is high, that's valuable information that leads to treatment.

Cholesterol screening is covered for all Medicare beneficiaries. This isn't a "nice to have" screening. This is something that tells you whether your parent needs medication to prevent heart disease. If your parent has never had cholesterol checked, or it's been years, this screening matters. High cholesterol often has no symptoms, so people don't realize they have it until the blood test shows the problem. Your parent should have their cholesterol checked regularly, at least every five years, and more often if they have risk factors.

If your parent has symptoms that suggest heart disease—like chest pain, shortness of breath during activity, or unusual fatigue—the doctor can order an EKG or stress test, and these are covered when medically necessary. These tests help determine whether your parent's heart is working properly. They're especially important if your parent has risk factors for heart disease like high blood pressure, high cholesterol, diabetes, or a family history.

If the doctor is concerned about heart disease based on screening results, they might discuss preventive medications. Aspirin therapy and statins are common examples. These medications help prevent heart attacks and strokes in people at risk. The medications themselves are usually inexpensive, but they're only helpful if your parent actually takes them regularly.

Cognitive and Mental Health Screenings

One screening that doesn't get talked about enough is cognitive screening. During the annual wellness visit, the doctor assesses your parent's thinking and memory. If the doctor sees any signs of decline, they can order more formal cognitive testing. This is different from a diagnosis of dementia. This is early detection of changes in thinking that warrant investigation.

Why this matters: catching cognitive decline early, before it becomes severe, gives your parent and your family time to plan. You can have conversations about what your parent wants to happen if decline continues. You can discuss finances, legal documents, and care preferences while your parent can still participate fully in those discussions. You can arrange for help before your parent reaches a crisis point.

Depression screening also happens during the wellness visit. Depression is common in older adults, it's often undiagnosed, and it's very treatable. If your parent has been sad, withdrawn, or less interested in things they used to enjoy, mention this to their doctor. Depression in older adults sometimes looks like physical symptoms,fatigue, pain, sleep problems,rather than obvious sadness. The screening is free, and if depression is identified, treatment is covered.

Vaccines Your Parent Probably Needs

The annual flu vaccine is the baseline. Every fall, your parent needs this vaccine. It takes five minutes, it's free, and it significantly reduces the risk of getting the flu and serious complications. If your parent has never had a serious flu or hasn't thought much about the flu, they might skip the vaccine. But severe flu in older adults can lead to pneumonia and hospitalization. The vaccine is easy and free.

Shingrix is the modern shingles vaccine, and if your parent is over 60 and hasn't received it, they should. Shingles is caused by reactivation of the chickenpox virus later in life. The rash is incredibly painful, and the pain can persist for months or even years after the rash heals. Most people over 70 would pay good money to prevent shingles if they could go back in time. They can get the vaccine now. It requires two doses, but both are covered completely.

Pneumonia vaccines have changed recently. The current recommendations are complex, but the bottom line is that most people over 65 need at least one pneumococcal vaccine if they haven't had the newer versions. Pneumonia can be serious in older adults, and the vaccine is covered. Your parent's doctor will know what vaccines your parent has had and what they still need.

The RSV vaccine is brand new, and it's something your parent should know about. If they're over 60, they can get this vaccine once. It helps prevent respiratory syncytial virus, which causes severe respiratory illness in older people. This isn't something from childhood immunization. This is a new protection that Medicare covers completely.

Using These Benefits Before It's Too Late

The key to actually getting these preventive services is treating the annual wellness visit as non-negotiable. Make the appointment in early fall, in plenty of time to get the flu vaccine and any other preventive care before winter. Make sure your parent actually goes. If your parent is reluctant to go to the doctor for "nothing wrong," remind them that early detection of something small is better than treatment of something big. And the visit is free.

When your parent goes to the wellness visit, they should mention any concerns, even if they seem minor. That pain in the knee. The occasional shortness of breath. Memory lapses. The doctor needs complete information to order appropriate screening. Your parent should bring a list of medications, even over-the-counter ones and supplements. And if the doctor recommends screening, your parent should do it.

One practical thing: if your parent doesn't have a primary care doctor, help them find one. The preventive care benefit is easiest to access through an ongoing relationship with a doctor who knows your parent's history. If your parent has been avoiding the doctor because they think they can't afford care, the preventive benefit changes the equation. Many things are free.

Early detection changes outcomes. A cancer found early is more treatable. A heart problem identified before a heart attack is preventable. A stroke risk factor found through blood pressure screening can be managed before a stroke happens. A cognitive change noticed early gives your parent time to plan. These aren't dramatic interventions. They're quiet prevention. But quiet prevention is how your parent gets more years with you, more years of independence, more years where they're still themselves. That's worth making the appointment for.

How To Help Your Elders is an educational resource. We do not provide medical, legal, or financial advice. The information in this article is general in nature and may not apply to your specific situation. If you are concerned about a loved one's cognitive health or safety, consult with their healthcare provider or contact your local Area Agency on Aging for guidance and support.