Medicare Preventive Services: Your Free Health Screenings Guide

Introduction: Taking Control of Your Health with Medicare Preventive Services

Your Medicare benefits include far more than just coverage for when you’re sick. Medicare Part B provides access to comprehensive preventive care services designed to keep you healthy, detect potential health problems early, and help you live your best life as you age. These preventive services represent one of Medicare’s most valuable yet underutilized benefits, offering you the opportunity to take proactive control of your health journey.

At PromiseCare Medical Group, the Inland Empire’s largest Independent Physician Association with over 60 primary care doctors and 400 specialists, our healthcare team understands the critical importance of preventive medicine. We’re committed to helping Medicare beneficiaries throughout Hemet, Murrieta, Temecula, Menifee, and Riverside County access the full range of free health screenings and preventive services available through their Medicare coverage.

Dr. Edivina Gonzales, an Internal Medicine physician with PromiseCare Medical Group, emphasizes this point: “Preventive care isn’t just about avoiding illness—it’s about empowering patients to understand their health status and make informed decisions. When Medicare beneficiaries take advantage of their free annual wellness visits and preventive screenings, we can identify risk factors before they develop into serious chronic diseases.”

The statistics are compelling. According to the Centers for Disease Control and Prevention, nearly 40% of all deaths in the United States are attributable to preventable causes, with chronic diseases like heart disease, diabetes, and cancer accounting for the majority of healthcare costs. Early detection through preventive screenings can reduce mortality from certain cancers and chronic conditions by 15 to 20 percent. Yet despite these proven benefits, only a small percentage of eligible Medicare beneficiaries take full advantage of their preventive services.

This comprehensive guide will help you understand exactly what preventive services Medicare covers, how to access them at no cost, and how the experienced physicians at PromiseCare Medical Group can partner with you to maximize these valuable benefits. Whether you’re new to Medicare or have been enrolled for years, understanding and utilizing your preventive care benefits is one of the most important steps you can take for your long-term health and well-being.

Understanding Medicare Preventive Services: Your Gateway to Proactive Health

Medicare’s preventive services framework represents a fundamental shift in healthcare philosophy—from reactive treatment of illness to proactive prevention and health promotion. These services are specifically designed to help you stay healthy, identify health problems in their earliest and most treatable stages, and manage existing conditions to prevent complications.

What Makes a Service “Preventive”?

The distinction between preventive and diagnostic services is crucial because it directly affects your out-of-pocket costs. Preventive services are designed for people without symptoms or known conditions, focusing on screening and early detection. Medicare covers these services at no cost to you when provided by healthcare providers who accept Medicare assignment, which includes all PromiseCare Medical Group physicians.

Diagnostic services, on the other hand, address existing symptoms or conditions. If during a preventive visit your doctor discovers a problem that requires further investigation or treatment, those additional services may be classified as diagnostic and subject to your usual cost-sharing responsibilities.

Dr. Bridget Briggs, a Family Practice physician at PromiseCare Medical Group, explains this important distinction: “During an annual wellness visit, we conduct comprehensive health assessments and screenings. If everything looks good, there’s no additional charge beyond your Medicare coverage. However, if we discover something that needs immediate attention—like significantly elevated blood pressure or an irregular heartbeat—addressing that concern may involve diagnostic care, which has different coverage rules.”

The Three Levels of Prevention in Medicare

Medicare’s preventive services encompass three distinct levels of prevention, each playing a vital role in your overall health strategy:

Primary Prevention focuses on preventing disease before it occurs. This includes immunizations like flu vaccines and pneumococcal shots, tobacco cessation counseling, and obesity counseling. These interventions aim to eliminate risk factors and prevent the onset of chronic conditions.

Secondary Prevention emphasizes early detection of disease through screenings when conditions are most treatable. This includes cancer screenings like mammography and colorectal cancer screening, cardiovascular disease screenings, diabetes screening, and bone density measurements. Early detection dramatically improves treatment outcomes and can prevent minor health issues from becoming major medical problems.

Tertiary Prevention involves managing existing chronic diseases to slow progression and prevent complications. This includes medical nutrition therapy for diabetes and chronic kidney disease, cardiac rehabilitation services, and diabetes self-management training. For Medicare beneficiaries already living with chronic conditions, these services are essential for maintaining quality of life and preventing costly complications.

How Medicare Preventive Services Save Lives and Money

The economic and health impact of preventive care cannot be overstated. Research demonstrates that intensive lifestyle interventions can reduce new cases of type 2 diabetes by more than 50%. Early detection of cardiovascular disease through preventive screening can identify hypertension and high cholesterol before they lead to heart attacks or strokes. Cancer screenings, when conducted according to recommended schedules, can catch malignancies at stages when they’re most responsive to treatment.

For Medicare beneficiaries, the financial benefits are equally significant. Because most preventive services are covered at 100% when you see providers who accept assignment, you can receive comprehensive health assessments, screenings, and counseling without worrying about copayments or deductibles. This removes financial barriers to care and ensures that cost never prevents you from accessing potentially life-saving screenings.

At PromiseCare Medical Group, all our physicians accept Medicare assignment, meaning you’ll never face unexpected charges for your covered preventive services. Our commitment to accessible, high-quality preventive care aligns perfectly with Medicare’s vision of keeping beneficiaries healthy and active throughout their retirement years.

Your Free Annual Wellness Visits: The Foundation of Preventive Care

The cornerstone of Medicare’s preventive services program is the annual wellness visit, a comprehensive health assessment that you can receive once every 12 months at no cost. These visits are distinctly different from traditional physical examinations and are specifically designed to develop or update your personalized prevention plan based on your current health status and risk factors.

Welcome to Medicare Preventive Visit: Your First Step

If you’re new to Medicare, your preventive care journey begins with the “Welcome to Medicare” preventive visit, also known as the Initial Preventive Physical Exam (IPPE). This one-time benefit is available within the first 12 months of your Medicare Part B enrollment and sets the foundation for your ongoing preventive care.

During your Welcome to Medicare visit, your PromiseCare physician will conduct a comprehensive baseline health assessment that includes:

Medical and Family History Review: Your doctor will document your complete medical history, including all current medications, chronic conditions, and family health history. Understanding your genetic predispositions and hereditary risk factors helps identify which preventive screenings will be most beneficial for you.

Physical Measurements and Vital Signs: Your height, weight, blood pressure, and body mass index will be recorded to establish baseline metrics. These measurements provide crucial reference points for tracking changes in your health over time and identifying early warning signs of conditions like hypertension or obesity.

Vision and Hearing Screening: Basic sensory assessments help identify age-related changes that could affect your quality of life and safety. Early detection of vision or hearing loss enables timely interventions that can prevent falls and maintain independence.

Preventive Services Education: Your physician will explain which screenings, immunizations, and preventive services are appropriate for you based on your age, sex, and health status. You’ll receive a written prevention plan outlining recommended services and their optimal timing.

Depression Screening: Mental health is an integral component of overall wellness. Your doctor will conduct a brief screening to assess for signs of depression, which affects millions of older adults but often goes unrecognized and untreated.

Advance Care Planning Discussion: Your physician will offer to discuss advance directives—legal documents that outline your preferences for medical treatment if you become unable to make decisions for yourself. While this conversation is optional, many patients find value in documenting their wishes while they’re healthy.

“The Welcome to Medicare visit is really about establishing a relationship and creating a roadmap for your healthcare journey,” explains a PromiseCare family medicine physician. “We’re not just checking boxes—we’re getting to know you as a whole person and identifying the preventive strategies that will have the greatest impact on your individual health.”

Annual Wellness Visits: Your Yearly Health Check-In

After you’ve had Medicare Part B for 12 months, you become eligible for your first Annual Wellness Visit (AWV), and you can receive this service once every 12 months thereafter. These visits build upon the foundation established during your Welcome to Medicare visit and provide ongoing preventive care coordination.

Your annual wellness visit typically includes:

Health Risk Assessment (HRA): You’ll complete a detailed questionnaire that evaluates your current health status, behavioral risk factors (like tobacco or alcohol use), psychosocial risks, and activities of daily living. This assessment helps your physician identify areas of concern and opportunities for health improvement.

Cognitive Assessment: Your doctor will evaluate your cognitive function to look for early signs of dementia or Alzheimer’s disease. Early detection of cognitive decline enables timely interventions and care planning that can help you and your family prepare for future care needs.

Review of Preventive Services Status: Your physician will check which preventive screenings and immunizations you’ve received and which are due based on current recommendations. This ensures you’re staying current with all appropriate preventive care.

Personalized Prevention Plan Update: Based on your Health Risk Assessment results and current health status, your doctor will update your prevention plan with specific recommendations for screenings, counseling services, and lifestyle modifications tailored to your needs.

Functional Ability and Safety Assessment: Your physician will evaluate your ability to perform activities of daily living, assess fall risk, and review your home safety. This proactive approach helps identify potential hazards before accidents occur.

Social Determinants of Health Assessment: Medicare now includes an optional assessment of social factors that impact health, such as food security, housing stability, transportation access, and social isolation. Identifying these challenges enables your healthcare team to connect you with community resources and support services.

Dr. Edivina Gonzales of PromiseCare Medical Group emphasizes the value of these annual visits: “Many of my patients are surprised to learn that the annual wellness visit isn’t a traditional physical exam. Instead, it’s a strategic planning session focused entirely on keeping you healthy. We’re looking ahead at your health risks and creating a customized prevention strategy rather than simply responding to existing problems.”

What’s Not Included in Your Wellness Visit

It’s important to understand that annual wellness visits are not comprehensive physical examinations. Traditional physical exams, which include detailed examinations of body systems and diagnostic testing for existing symptoms, are not covered as part of your free wellness visit.

If during your wellness visit your physician identifies a health concern that requires immediate attention, evaluation, or treatment beyond the scope of preventive care, those services will be billed separately as diagnostic care. You may have copayments and deductibles for these additional services.

For example, if your routine blood pressure check during your wellness visit reveals significantly elevated readings, your doctor may want to perform additional tests or begin treatment. These diagnostic services would not be covered under your free wellness visit benefit.

This is why PromiseCare physicians encourage patients to schedule separate appointments for specific health concerns rather than trying to address them during wellness visits. “If you’re experiencing symptoms like chest pain, persistent cough, or worrisome changes in your health, don’t wait for your annual wellness visit,” advises a PromiseCare internal medicine specialist. “Schedule a problem-focused visit right away so we can address your concerns appropriately and ensure you receive the care you need.”

Comprehensive Cancer Screening: Early Detection Saves Lives

Cancer remains one of the leading causes of death among older adults, but early detection through regular screening dramatically improves survival rates. Medicare covers several cancer screenings at no cost when provided by physicians who accept assignment, like those at PromiseCare Medical Group.

Colorectal Cancer Screening: Multiple Options for Complete Protection

Colorectal cancer is highly preventable when detected early, yet it remains the third most common cancer diagnosis in the United States. Medicare provides comprehensive coverage for several colorectal cancer screening methods, recognizing that different patients may prefer different screening approaches.

Colonoscopy: Medicare covers screening colonoscopies once every 10 years for average-risk beneficiaries (or more frequently if you’re at high risk). This procedure allows your physician to examine the entire colon and remove precancerous polyps during the same procedure, providing both screening and prevention in one service.

Flexible Sigmoidoscopy: Covered once every 48 months, this procedure examines the lower portion of the colon. If polyps or other abnormalities are found, a full colonoscopy may be recommended.

Fecal Occult Blood Test: This at-home test, which checks stool samples for hidden blood, is covered once every 12 months. Recent studies show that stool-based testing can achieve participation rates 40% higher than colonoscopy, making it an excellent option for patients who face barriers to traditional screening.

Multi-Target Stool DNA Test: Covered once every three years, this advanced screening test (like Cologuard) detects both blood and altered DNA in stool samples, providing highly sensitive cancer detection.

“Colorectal cancer screening is one of the most effective preventive services available,” notes a PromiseCare gastroenterology specialist. “We can actually prevent cancer by removing polyps before they become malignant. Yet many eligible patients delay or skip screening. I encourage everyone over 50 to discuss their screening options with their primary care provider and choose the method they’re most comfortable completing.”

Breast Cancer Screening: Protecting Women’s Health

Breast cancer screening through mammography is one of Medicare’s most utilized preventive services, and for good reason—early detection significantly improves treatment outcomes and survival rates.

Screening Mammograms: Medicare covers annual screening mammograms for all women age 40 and older. These X-ray examinations can detect breast cancer up to three years before a lump can be felt, enabling treatment at the earliest and most curable stages.

Diagnostic Mammograms: If abnormalities are found on a screening mammogram, Medicare covers more frequent diagnostic mammograms to investigate the findings. These are considered diagnostic rather than preventive services and may involve cost-sharing.

Baseline Mammogram: Women ages 35-39 can receive one baseline mammogram to establish a comparison for future screenings.

PromiseCare’s network includes multiple imaging centers throughout Riverside County, making it convenient for Medicare beneficiaries to schedule and complete their annual mammography screenings close to home.

Prostate Cancer Screening: Protecting Men’s Health

For male Medicare beneficiaries, prostate cancer screening is available once every 12 months for those over age 50. This screening includes:

Digital Rectal Exam (DRE): A physical examination to check the prostate for abnormalities.

Prostate-Specific Antigen (PSA) Test: A blood test that measures PSA levels, which may be elevated in men with prostate cancer.

“Prostate cancer screening has evolved significantly in recent years,” explains a PromiseCare urologist. “We now have a much better understanding of which men benefit most from screening and when active surveillance may be more appropriate than aggressive treatment. During your annual wellness visit, your primary care physician can help you understand your individual risk factors and make informed screening decisions.”

Cervical and Vaginal Cancer Screening: Comprehensive Women’s Health Protection

Medicare covers comprehensive screening for cervical and vaginal cancers through Pap tests and pelvic examinations.

Pap Test and Pelvic Exam: All women with Medicare are covered for these screenings once every 24 months. Women at high risk for cervical or vaginal cancer, or those with abnormal results in the past three years, qualify for annual screening.

HPV Testing: For women ages 30-65, Medicare covers human papillomavirus (HPV) testing as part of Pap tests once every five years when there are no HPV symptoms.

These screenings are particularly important because cervical cancer is highly preventable when precancerous changes are detected and treated early.

Lung Cancer Screening: Protection for Current and Former Smokers

Medicare covers annual lung cancer screening with low-dose computed tomography (CT) for beneficiaries who meet specific criteria:

• Ages 50 to 80 years old
• Have a tobacco smoking history of at least 20 pack-years
• Currently smoke or have quit within the past 15 years
• Receive a written order from a physician

Before your first lung cancer screening, you must have a counseling visit with your doctor to discuss the benefits and risks of screening. Subsequent annual screenings require a shared decision-making visit.

“Lung cancer screening represents one of the most significant advances in preventive medicine for current and former smokers,” notes a PromiseCare pulmonologist. “Early-stage lung cancer is far more treatable than advanced disease, and screening gives us the opportunity to detect cancer when treatment is most effective. If you have a significant smoking history, this is a conversation worth having with your primary care provider.”

Cardiovascular Disease Prevention: Protecting Your Heart Health

Heart disease remains the leading cause of death in the United States, but many risk factors for cardiovascular disease are identifiable and treatable through preventive screening. Medicare’s cardiovascular disease prevention services provide comprehensive protection for your heart health.

Blood Pressure Screening: The Silent Killer Detection

High blood pressure, often called the “silent killer” because it typically has no symptoms, affects nearly half of all American adults. Left untreated, hypertension significantly increases your risk of heart attack, stroke, kidney disease, and other serious complications.

Medicare covers blood pressure checks as part of many preventive and diagnostic services, including your annual wellness visit. However, if you have concerns about your blood pressure between wellness visits, schedule a separate appointment with your PromiseCare physician.

“Home blood pressure monitoring has become increasingly important in managing hypertension,” explains Dr. Edivina Gonzales of PromiseCare Medical Group. “We encourage patients to track their blood pressure at home and bring those readings to appointments. This gives us a more complete picture of their cardiovascular health and helps us make more informed treatment decisions.”

Cardiovascular Disease Screening: Comprehensive Risk Assessment

Medicare covers cardiovascular disease screening blood tests once every five years. These tests check your cholesterol, lipid, and triglyceride levels to assess your risk of heart disease and stroke.

The screening includes:

Total Cholesterol Measurement: Evaluates overall cholesterol levels in your blood.

LDL (Bad) Cholesterol: Measures low-density lipoprotein, which can build up in arteries and increase heart disease risk.

HDL (Good) Cholesterol: Assesses high-density lipoprotein, which helps remove bad cholesterol from your bloodstream.

Triglycerides: Checks levels of this fat type in your blood, which at elevated levels increases cardiovascular disease risk.

Based on your results, your physician may recommend more frequent monitoring or interventions like dietary changes, increased physical activity, or medication to manage cholesterol levels.

Cardiovascular Behavioral Therapy: Reducing Heart Disease Risk

For Medicare beneficiaries with specific cardiovascular disease risk factors, Medicare covers intensive behavioral therapy to reduce these risks. You may qualify if you have:

• Obesity (BMI of 30 or higher)
• High blood pressure
• High cholesterol
• Prediabetes or diabetes

This counseling, provided by qualified primary care physicians or other healthcare professionals in primary care settings, focuses on:

• Heart-healthy nutrition education
• Physical activity recommendations
• Weight loss strategies
• Stress management techniques
• Tobacco cessation support

PromiseCare Medical Group physicians are specially trained in providing cardiovascular behavioral therapy and work closely with patients to develop personalized risk reduction strategies.

Abdominal Aortic Aneurysm Screening: One-Time Protection

Medicare provides one-time screening for abdominal aortic aneurysm (AAA) using ultrasound technology. This benefit is available if you:

• Have a family history of AAA
• Are a man ages 65-75 who has smoked at least 100 cigarettes in your lifetime
• Meet other risk criteria determined by your physician

AAA screening can detect dangerous weakening and ballooning of the major artery in your abdomen, allowing for monitoring or treatment before a life-threatening rupture occurs.

Diabetes Prevention and Management: Stopping Diabetes Before It Starts

Diabetes affects over 38 million Americans, with type 2 diabetes representing the vast majority of cases. Medicare offers comprehensive preventive services designed both to prevent diabetes in at-risk individuals and to help those with diabetes manage their condition effectively.

Diabetes Screening: Know Your Numbers

Medicare covers diabetes screening tests twice per year if you have any of these risk factors:

• High blood pressure (hypertension)
• High cholesterol and triglyceride levels
• Obesity
• History of high blood sugar (glucose)
• Family history of diabetes

The screening measures your blood glucose (sugar) levels through fasting blood tests or glucose tolerance tests. Early detection of prediabetes—when blood sugar levels are elevated but not yet in the diabetes range—provides a critical window for prevention interventions.

“Many people with prediabetes don’t have any symptoms, which is why screening is so important,” notes a PromiseCare endocrinologist. “When we catch prediabetes early, intensive lifestyle interventions can reduce the progression to type 2 diabetes by more than 50%. But you can’t intervene if you don’t know you have a problem, which is why we encourage all at-risk patients to get screened.”

Medicare Diabetes Prevention Program: Stopping Diabetes in Its Tracks

For Medicare beneficiaries diagnosed with prediabetes, the Medicare Diabetes Prevention Program (MDPP) offers a structured behavior change program at no cost. This evidence-based program has been proven to prevent or delay the onset of type 2 diabetes in high-risk individuals.

The MDPP includes:

Core Sessions: 16 weekly sessions offered in group settings over six months, focusing on lifestyle change strategies including healthy eating, physical activity, and behavior modification.

Maintenance Sessions: After completing the core program, participants attend monthly maintenance sessions to reinforce healthy habits and sustain weight loss.

Trained Coaches: Sessions are led by trained lifestyle coaches who guide participants through the program and provide ongoing support and accountability.

To qualify for the MDPP, you must:

• Have a body mass index (BMI) of 25 or higher (23 or higher if Asian)
• Have a blood test showing prediabetes within the past year
• Not have end-stage renal disease
• Have never previously participated in the MDPP

The program’s goal is to help participants lose 5% of their body weight through sustainable lifestyle changes, significantly reducing their risk of developing type 2 diabetes.

Diabetes Self-Management Training: Empowering Better Control

For Medicare beneficiaries who have diabetes, Medicare covers diabetes self-management training to help you effectively manage your condition and prevent complications. This comprehensive educational program includes:

Individual and Group Training: Sessions taught by certified diabetes educators covering all aspects of diabetes management.

Blood Glucose Monitoring: Education on proper testing techniques, understanding results, and using data to adjust treatment.

Nutrition Education: Personalized meal planning guidance and strategies for maintaining stable blood sugar through diet.

Medication Management: Understanding how and when to take diabetes medications for optimal effectiveness.

Complication Prevention: Learning to recognize warning signs and prevent serious diabetes complications like neuropathy, retinopathy, and cardiovascular disease.

Medicare covers up to 10 hours of initial training (with possible additional hours if recommended by your physician) and two hours of follow-up training each year thereafter.

Medical Nutrition Therapy: Specialized Dietary Counseling

For Medicare beneficiaries with diabetes or kidney disease, Medicare covers medical nutrition therapy services provided by registered dietitians. This service includes:

Nutritional Assessment: Comprehensive evaluation of your dietary habits, nutritional status, and specific health concerns.

Personalized Nutrition Plan: Customized meal planning strategies designed to manage your condition while meeting your nutritional needs and preferences.

Follow-Up Counseling: Regular sessions to monitor progress, address challenges, and adjust your nutrition plan as needed.

Medicare covers three hours of medical nutrition therapy in the first year following your diabetes diagnosis, plus two hours annually thereafter. Those with kidney disease receive similar coverage.

Bone Health and Osteoporosis Prevention

Osteoporosis and bone fractures represent major health threats for older adults, particularly women. Medicare’s bone health screening services help identify at-risk individuals before fractures occur.

Bone Density Measurement: Preventing Fractures Before They Happen

Medicare covers bone mass measurements (bone density tests) once every 24 months, or more frequently if medically necessary, for beneficiaries who meet certain criteria:

• Women age 65 and older
• Women whose estrogen levels are deficient and at risk for osteoporosis
• Individuals with certain medical conditions or taking medications that increase fracture risk
• People with vertebral abnormalities suggesting osteoporosis
• Individuals being monitored to assess the response to or efficacy of osteoporosis drug therapy

The test uses low-radiation X-rays (DEXA scan) to measure bone mineral density, typically at the hip and spine. Results help your physician determine your fracture risk and whether preventive treatment is appropriate.

“Bone health often doesn’t get the attention it deserves until someone suffers a fracture,” notes a PromiseCare primary care physician. “But by that point, significant bone loss has already occurred. Preventive screening allows us to identify people at risk and implement protective strategies before fractures happen, preserving mobility and independence.”

Mental Health and Substance Use Screening

Mental health is an integral component of overall wellness, yet mental health conditions in older adults often go unrecognized and untreated. Medicare’s mental health screening services provide important safeguards.

Depression Screening: Addressing the Hidden Epidemic

Medicare covers annual depression screening for all beneficiaries. During this screening, your physician will ask you a series of questions designed to identify symptoms of depression. You must receive screening in a primary care setting where follow-up treatment and referrals are available.

Depression affects millions of older adults but often presents differently than in younger people. Symptoms may include:

• Persistent sadness or empty mood
• Loss of interest in activities previously enjoyed
• Changes in appetite or weight
• Sleep disturbances
• Fatigue or decreased energy
• Difficulty concentrating or making decisions
• Physical symptoms without clear medical cause

“Depression isn’t a normal part of aging,” emphasizes Dr. Edivina Gonzales of PromiseCare Medical Group. “Yet many older adults dismiss their symptoms or feel stigmatized about seeking help. Depression screening removes that barrier and opens the door to effective treatment that can dramatically improve quality of life.”

Alcohol Misuse Screening and Counseling

Medicare covers one alcohol misuse screening per year for adults, including questions about alcohol consumption patterns. If your primary care physician determines you’re misusing alcohol, Medicare covers up to four brief face-to-face counseling sessions per year in a primary care setting.

These interventions address alcohol use before it progresses to alcohol dependency, helping beneficiaries reduce harmful drinking patterns and avoid serious health consequences.

Immunizations: Protection Against Preventable Diseases

Vaccines remain one of the most cost-effective preventive health interventions available. Medicare provides comprehensive coverage for several important immunizations.

Flu Vaccine: Annual Protection

Medicare covers seasonal influenza vaccines once per flu season with no cost-sharing. The flu poses particular risks for older adults, who are more likely to experience serious complications including hospitalization and death.

Getting vaccinated annually protects not only your own health but also helps protect vulnerable individuals in your community who cannot be vaccinated.

Pneumococcal Vaccines: Preventing Serious Lung Infections

Medicare covers pneumococcal vaccines that protect against pneumonia, meningitis, and bloodstream infections caused by pneumococcal bacteria. Coverage includes all recommended pneumococcal vaccines with no out-of-pocket costs.

The Centers for Disease Control and Prevention recommends that adults 65 and older receive both PCV15 or PCV20 and PPSV23 vaccines for complete protection.

COVID-19 Vaccines: Ongoing Protection

Medicare covers COVID-19 vaccines and boosters at no cost to beneficiaries. As new variants emerge and vaccine formulations are updated, Medicare continues to provide coverage for recommended COVID-19 vaccinations.

Hepatitis B Vaccine: Protection for At-Risk Individuals

Medicare covers hepatitis B vaccines for beneficiaries at medium to high risk for hepatitis B infection. Risk factors include:

• End-stage renal disease
• Diabetes (for those under age 60)
• Certain types of healthcare work
• Living with someone who has hepatitis B

The vaccine series typically involves three doses over six months.

Additional Preventive Services: Comprehensive Health Protection

Medicare’s preventive services extend well beyond the major screenings and immunizations already discussed, providing comprehensive protection across multiple health domains.

Glaucoma Screening: Protecting Your Vision

Medicare covers glaucoma screening once every 12 months for beneficiaries at high risk, including:

• People with diabetes
• Individuals with a family history of glaucoma
• African Americans age 50 and older
• Hispanic Americans age 65 and older

Early detection of glaucoma allows for treatment that can prevent or slow vision loss from this “silent thief of sight.”

Tobacco Cessation Counseling: Breaking Free from Smoking

For Medicare beneficiaries who use tobacco, Medicare covers up to eight counseling sessions during a 12-month period. These sessions, which must be provided by qualified physicians or other healthcare professionals, offer evidence-based strategies for quitting tobacco use.

Tobacco cessation is one of the single most important steps anyone can take to improve their health. Former smokers experience reduced risks of heart disease, stroke, lung disease, and cancer, with health benefits beginning almost immediately after quitting.

Hepatitis C Screening: One-Time Protection

Medicare covers one-time hepatitis C screening for beneficiaries at high risk, which includes:

• Current or former injection drug users
• Recipients of blood transfusions before 1992
• Long-term hemodialysis patients
• People with known hepatitis C exposure
• People born between 1945 and 1965

Early detection of hepatitis C enables treatment that can cure the infection and prevent liver damage.

HIV Screening and PrEP: Comprehensive HIV Prevention

Medicare covers HIV screening up to three times per year for beneficiaries at increased risk, once per year for pregnant women, and once for beneficiaries who request it without risk factors.

For beneficiaries at high risk for HIV who test negative, Medicare also covers:

• FDA-approved HIV prevention medication (PrEP)
• Counseling services
• Regular HIV screenings
• One-time hepatitis B screening

Sexually Transmitted Infection Screening: Protecting Sexual Health

Medicare covers sexually transmitted infection (STI) screening and behavioral counseling for sexually active adults at increased risk. Services include:

• Screening for chlamydia, gonorrhea, syphilis, and hepatitis B
• Up to two individual behavioral counseling sessions per year (each 20-30 minutes)

These services acknowledge that sexual health remains important throughout life and provide age-appropriate preventive care.

Accessing Your Preventive Services Through PromiseCare Medical Group

Understanding your Medicare preventive service benefits is the first step—actually accessing these services is where PromiseCare Medical Group excels. As the Inland Empire’s largest Independent Physician Association, PromiseCare offers unparalleled access to preventive care throughout Riverside County.

Why Choose PromiseCare for Your Preventive Care

Comprehensive Network: With over 60 primary care physicians and 400 specialists, PromiseCare ensures you have access to all Medicare-covered preventive services close to home. Our network includes physicians in Hemet, Murrieta, Temecula, Menifee, Lake Elsinore, San Jacinto, and throughout Riverside County.

Medicare Assignment Acceptance: All PromiseCare physicians accept Medicare assignment, meaning you’ll never face unexpected charges for your covered preventive services. What Medicare says they’ll cover is exactly what you’ll receive—with no surprise bills.

Coordinated Care Approach: Your PromiseCare primary care physician serves as your health advocate, coordinating all aspects of your preventive care including scheduling screenings, tracking due dates, and ensuring you’re current with all recommended services.

Convenient Scheduling: With 18 urgent care centers and numerous primary care offices throughout the region, scheduling and completing your preventive services has never been easier.

Experienced Medicare Specialists: PromiseCare physicians have extensive experience working with Medicare beneficiaries and understand the nuances of Medicare coverage, ensuring you maximize your benefits.

Scheduling Your Annual Wellness Visit

The first step in accessing your Medicare preventive services is scheduling your annual wellness visit. Here’s how to get started:

New to Medicare: If you’re within your first 12 months of Medicare Part B coverage, request a “Welcome to Medicare” preventive visit when calling to schedule.

Established Medicare Beneficiary: If you’ve had Part B for more than 12 months, request your annual wellness visit. Remember, you must wait 11 full months between wellness visits.

Prepare for Your Visit: Before your appointment, complete any Health Risk Assessment forms provided by your physician’s office. Gather your medication list, immunization records, and any recent test results from other healthcare providers.

Bring Your Questions: Your annual wellness visit is the perfect time to discuss which preventive screenings are right for you and to address any health concerns you may have.

What to Expect at Your PromiseCare Preventive Visit

When you arrive for your annual wellness visit at any PromiseCare location, you can expect:

Welcoming Environment: Our staff understands that healthcare can be intimidating. We strive to create a comfortable, welcoming atmosphere where you feel valued and heard.

Thorough Assessment: Your physician will conduct a comprehensive evaluation of your health status, risk factors, and preventive care needs. This isn’t a rushed appointment—we allocate adequate time for meaningful discussion.

Personalized Prevention Plan: You’ll leave with a clear understanding of which screenings and preventive services you should complete, when they’re due, and why they’re important for your specific health situation.

Coordination of Care: If additional screenings or services are recommended, our staff can help you schedule these appointments and ensure you receive all necessary care in a timely manner.

Follow-Up Support: Between wellness visits, PromiseCare’s care coordination team monitors your preventive care status and reaches out with reminders when screenings are due.

Questions to Ask Your PromiseCare Physician

To maximize the value of your preventive care visits, consider asking your physician:

• Which preventive screenings are most important for me based on my age, sex, and health history?
• Am I up to date with all recommended immunizations?
• Do any of my current health conditions or family history put me at higher risk for specific diseases?
• What lifestyle changes would have the greatest impact on my long-term health?
• Are there any preventive services I’m eligible for that I haven’t been taking advantage of?
• What’s the best way to remember when my screenings are due?
• Do I need referrals to specialists for any of my preventive care services?

Understanding Cost-Sharing for Preventive Services

One of the most valuable aspects of Medicare’s preventive services is that most are provided at no cost when you receive care from providers who accept Medicare assignment. However, understanding exactly when services are free and when cost-sharing may apply is essential.

When You Pay Nothing

You pay nothing for Medicare-covered preventive services when all of the following conditions are met:

• The service is on Medicare’s list of covered preventive services
• Your healthcare provider accepts Medicare assignment (all PromiseCare physicians do)
• You meet the eligibility criteria for the specific service (age, risk factors, etc.)
• The service is provided according to Medicare’s coverage schedule (not too frequently)
• The service remains preventive in nature (no diagnostic testing or treatment during the visit)

When Cost-Sharing May Apply

You may have to pay copayments, coinsurance, or deductibles if:

• Your provider performs additional tests or services during your preventive visit that Medicare doesn’t cover under preventive benefits
• Your provider investigates or treats a health issue discovered during your preventive visit
• You receive preventive services more frequently than Medicare covers
• Your provider doesn’t accept Medicare assignment (not applicable at PromiseCare)
• You have Original Medicare but receive services from an out-of-network provider in a Medicare Advantage plan

The Importance of Asking Before Your Visit

To avoid surprise charges, always confirm before your appointment that:

• The service you’re receiving is classified as preventive under Medicare
• Your provider accepts Medicare assignment
• You’re eligible for the service based on Medicare’s coverage criteria
• You understand which portions of your visit are preventive (no cost) and which, if any, are diagnostic (may involve cost-sharing)

PromiseCare’s billing staff is always available to answer coverage questions before your appointments, ensuring you’re never caught off guard by unexpected charges.

Maximizing Your Medicare Preventive Benefits: A Year-Round Strategy

Getting the most value from your Medicare preventive services requires a proactive, year-round approach rather than treating preventive care as an annual checkbox exercise.

Create Your Personal Preventive Care Calendar

Work with your PromiseCare physician to develop a calendar outlining when each of your preventive services is due. This might include:

• Annual wellness visit (once every 12 months)
• Flu vaccine (once per flu season, typically fall)
• Cancer screenings (varies by type and risk factors)
• Cardiovascular screening (every five years)
• Bone density test (every 24 months if eligible)
• Depression screening (annually)
• Other services based on your individual needs

Set Reminders and Track Your Care

Use whatever system works best for you to remember upcoming screenings:

• Calendar reminders on your phone or computer
• Written notes on a wall calendar
• Enrollment in PromiseCare’s care coordination program for automatic reminders
• Keeping a health journal with upcoming appointment dates

Don’t Wait for Symptoms

The whole point of preventive care is identifying problems before symptoms appear. Don’t delay screenings thinking “I feel fine, so I don’t need to bother.” Many serious conditions—including high blood pressure, high cholesterol, early-stage cancer, and diabetes—have no symptoms in their early stages.

Combine Appointments When Possible

When appropriate, coordinate multiple preventive services during a single appointment to reduce the number of separate visits required. For example, your annual wellness visit might include depression screening, blood pressure checks, and review of your immunization status.

However, never try to combine preventive and diagnostic care in a single visit, as this may result in unexpected charges.

Follow Through on Referrals

If your annual wellness visit reveals that you need additional screenings or specialist consultations, schedule those appointments promptly. The benefit of preventive care is lost if you identify concerns but don’t take action to address them.

Track Your Results

Keep a personal health record documenting your preventive service results. This information helps you and your healthcare team track changes over time and make informed decisions about your care.

Special Considerations for Medicare Advantage Plans

While this guide has focused primarily on Original Medicare (Parts A and B), it’s important to note that Medicare Advantage plans must cover all preventive services that Original Medicare covers—and many offer additional benefits.

Medicare Advantage Preventive Care Coverage

If you have a Medicare Advantage plan (Part C) that includes PromiseCare providers in its network, you’re entitled to all the preventive services covered by Original Medicare at no cost when you see in-network providers.

Many Medicare Advantage plans offer extra benefits beyond Original Medicare, which may include:

• Dental preventive care (cleanings, exams, X-rays)
• Vision care (routine eye exams, eyeglasses or contact allowances)
• Hearing care (hearing exams, hearing aid benefits)
• Fitness programs (gym memberships, fitness classes)
• Over-the-counter medication allowances
• Telehealth preventive visits
• Additional wellness programs

Confirming Your Coverage

Before scheduling preventive services, confirm with your specific Medicare Advantage plan:

• Which PromiseCare providers are in-network for preventive care
• Whether any prior authorization is required for certain screenings
• What your specific copayments or cost-sharing responsibilities are
• Whether you need referrals from your primary care physician for specialist preventive services

PromiseCare’s experienced staff can help you navigate your Medicare Advantage plan’s requirements and ensure you maximize your benefits.

Addressing Common Barriers to Preventive Care

Despite the availability of free preventive services, many Medicare beneficiaries don’t take full advantage of these benefits. Understanding and overcoming common barriers is essential for protecting your health.

“I Don’t Have Time”

Life gets busy, and healthcare appointments often take a backseat to other responsibilities. However, investing a few hours per year in preventive care can save weeks or months dealing with serious illnesses that could have been prevented or detected early.

PromiseCare offers convenient appointment times, including early morning and late afternoon slots to accommodate various schedules. Additionally, our 18 urgent care centers throughout Riverside County provide flexible options for walk-in preventive services like immunizations.

“I Feel Fine, So I Don’t Need Screenings”

Many serious conditions develop silently, producing no symptoms until they’ve advanced to dangerous stages. High blood pressure, high cholesterol, early-stage cancers, diabetes, and osteoporosis often have no noticeable symptoms in their early, most treatable stages.

Preventive screenings are designed specifically to catch these silent conditions before you feel sick. By the time symptoms appear, the condition may be far more difficult and expensive to treat.

“I’m Worried About What They Might Find”

Fear of bad news keeps many people from preventive care. However, avoiding screenings doesn’t prevent disease—it only prevents early detection when treatment is most effective.

Consider this perspective: Would you rather discover a health problem early when it’s most treatable, or late when treatment options are limited and less effective? Early detection saves lives.

“I Can’t Afford Healthcare”

If cost concerns are preventing you from accessing preventive care, remember that most Medicare preventive services are completely free when you see providers who accept assignment, like all PromiseCare physicians.

Additionally, PromiseCare’s staff can help you explore additional assistance programs if you’re struggling with healthcare costs for services beyond preventive care.

“I Don’t Understand What Services I Need”

Healthcare can be confusing, especially with complex insurance rules and numerous screening options. This is precisely why your annual wellness visit is so valuable—it’s an opportunity to sit down with your PromiseCare physician and develop a clear, personalized prevention plan explaining exactly what you need and why.

Never hesitate to ask questions. PromiseCare physicians are committed to patient education and ensuring you understand your healthcare options.

The Future of Preventive Care: Innovation and Improvement

Medicare’s preventive services continue to evolve as new screening technologies emerge and our understanding of disease prevention improves. Staying informed about changes to preventive care guidelines ensures you’re receiving the most current, evidence-based care.

Emerging Preventive Technologies

New screening technologies are constantly under development, including:

• Liquid biopsy tests that can detect multiple types of cancer through a simple blood draw
• Advanced imaging techniques that provide earlier disease detection with less radiation exposure
• Genetic screening to identify individuals at high risk for specific conditions
• Artificial intelligence tools that improve screening accuracy and identify subtle disease signs

As these technologies prove their effectiveness and safety, Medicare periodically reviews and updates its coverage policies to include new preventive services.

Evolving Guidelines

Preventive care guidelines from organizations like the U.S. Preventive Services Task Force are regularly updated based on new research. These updates may change:

• Recommended ages for starting or stopping certain screenings
• Frequency of screening intervals
• Target populations for specific preventive services

Your PromiseCare physician stays current with these guideline updates, ensuring your preventive care plan reflects the latest evidence-based recommendations.

Patient-Centered Preventive Care

The future of preventive medicine is increasingly personalized, moving beyond one-size-fits-all screening schedules to consider individual risk factors, genetic predispositions, lifestyle factors, and patient preferences.

PromiseCare embraces this patient-centered approach, recognizing that the most effective prevention plan is one that’s tailored to your unique health profile and circumstances.

Frequently Asked Questions About Medicare Preventive Services

Q: How soon after enrolling in Medicare can I get my Welcome to Medicare visit?

A: You can schedule your Welcome to Medicare preventive visit anytime within the first 12 months after enrolling in Medicare Part B. It’s best to schedule this visit early in your Medicare coverage to establish your baseline health assessment and begin receiving appropriate preventive services right away.

Q: What’s the difference between a preventive visit and a physical exam?

A: A preventive visit (like your annual wellness visit) focuses specifically on preventive care planning, health risk assessment, and screening coordination. It’s not a traditional head-to-toe physical examination. Physical exams that include comprehensive body system examinations and diagnostic testing are separate services that aren’t covered under Medicare’s free preventive benefits.

Q: Can I have both my annual wellness visit and my Welcome to Medicare visit in the same year?

A: No. You must wait at least 11 full months after your Welcome to Medicare visit before receiving your first annual wellness visit. However, you don’t need to have a Welcome to Medicare visit to qualify for annual wellness visits—if you skip the Welcome to Medicare visit, you can get your first annual wellness visit 12 months after your Part B coverage begins.

Q: Will my preventive screenings be completely free even if they find a problem?

A: Preventive screenings themselves are free when you meet Medicare’s coverage criteria and see providers who accept assignment. However, if a screening reveals a problem that requires additional testing, evaluation, or treatment beyond the scope of preventive care, those additional services may be classified as diagnostic and subject to normal cost-sharing. Your PromiseCare physician can help you understand which services remain preventive and which might involve additional costs.

Q: How do I know which preventive services are right for me?

A: Your PromiseCare physician will evaluate your individual risk factors, health history, age, and current health status to recommend appropriate preventive services during your annual wellness visit. Medicare’s coverage criteria provide general guidelines, but your doctor will personalize recommendations based on your specific circumstances.

Q: Do I need referrals to get preventive services from specialists?

A: This depends on whether you have Original Medicare or a Medicare Advantage plan. Original Medicare doesn’t require referrals for most preventive services. However, Medicare Advantage plans may have different rules about referrals and network requirements. PromiseCare’s staff can help you understand your specific plan’s requirements.

Q: What happens if I forget to schedule my preventive services?

A: PromiseCare’s care coordination team helps track when your preventive services are due and can send reminders when it’s time to schedule appointments. However, you’re ultimately responsible for scheduling and attending your preventive care visits. Don’t wait for reminders—take an active role in your health by marking important screening dates on your personal calendar.

Q: Can I refuse preventive services that my doctor recommends?

A: Yes. Preventive services are recommendations, not requirements. However, we strongly encourage you to discuss any concerns about recommended screenings with your physician. Often, fears or misconceptions can be addressed through education, and the benefits of preventive care far outweigh the minimal risks of most screenings.

Q: Will Medicare pay for preventive services I get from providers outside the PromiseCare network?

A: If you have Original Medicare (Parts A and B), you can receive covered preventive services from any provider who accepts Medicare, though staying within PromiseCare’s network ensures coordinated care and the best possible outcomes. If you have a Medicare Advantage plan, check your plan’s network requirements—most Medicare Advantage plans require you to use in-network providers for covered services.

Q: How can I find out what preventive services I’ve already received?

A: You can log into your secure Medicare account at Medicare.gov to view your preventive services history. Additionally, PromiseCare maintains comprehensive health records for all patients, and your physician can review which preventive services you’ve received and which are due at your annual wellness visit.

Take Action: Schedule Your Preventive Care Today

Your health is your most valuable asset, and Medicare’s comprehensive preventive services provide you with powerful tools to protect that investment. The benefits are clear: early detection saves lives, preventive care reduces healthcare costs, and proactive health management enables you to enjoy your retirement years with vitality and independence.

Your Next Steps

Step 1: Contact PromiseCare Medical Group

Call (951) 390-2840 to schedule your annual wellness visit or Welcome to Medicare preventive visit. Our friendly staff will help you find a convenient appointment time at one of our many locations throughout Riverside County.

Step 2: Prepare for Your Visit

Gather your medication list, complete any Health Risk Assessment forms you receive, and note any health questions or concerns you want to discuss with your physician.

Step 3: Attend Your Appointment

Come prepared to discuss your health status, risk factors, and preventive care needs. Don’t rush—this visit is about you and your health.

Step 4: Follow Through

Schedule any recommended screenings or specialist consultations promptly. The benefit of preventive care is only realized when you take action on the recommendations.

Step 5: Create Your Prevention Calendar

Work with your PromiseCare physician to establish a schedule for all your preventive services and set reminders to ensure you never miss important screenings.

A Commitment to Your Health

At PromiseCare Medical Group, we’re committed to being your partners in health and wellness. Our network of over 60 primary care physicians and 400 specialists stands ready to provide you with the comprehensive, coordinated preventive care you deserve.

Don’t wait for illness to force you into the healthcare system. Take control of your health today by scheduling your Medicare preventive services. Your future self will thank you for the investment you’re making in your long-term health and well-being.

For more information about Medicare preventive services or to schedule your annual wellness visit, contact PromiseCare Medical Group today. Together, we’ll create a personalized prevention plan that keeps you healthy, active, and independent for years to come.

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About PromiseCare Medical Group

PromiseCare Medical Group is the Inland Empire’s largest and longest continuously serving Independent Physician Association, with over 60 primary care physicians, 400+ specialists, and 18 urgent care centers serving Hemet, Murrieta, Temecula, Menifee, Lake Elsinore, San Jacinto, and throughout Riverside County. We accept all major Medicare Advantage plans and are committed to providing accessible, high-quality preventive and acute care to Medicare beneficiaries throughout the region.

Contact Information:
PromiseCare Medical Group
1565 W. Florida Ave.
Hemet, CA 92543
Phone: (951) 390-2840
TTY: 711
Website: https://promisecare.com

Office Hours:
Monday-Friday: 8:00 AM – 5:00 PM
Saturday-Sunday: Closed

All PromiseCare physicians accept Medicare assignment, ensuring you receive covered preventive services at no cost to you.