Are You Using All Your Medicare Preventive Services? Most Seniors Aren’t

To be honest, most seniors are not getting the free preventive care they need. I’m not talking about a vague benefit that you’ll never use. I’m talking about real screenings and services that Medicare already pays for, and they are often free for you.

But millions of people skip them every year. Why? Sometimes it’s just confusion. Sometimes it’s because people don’t know. And to be honest, sometimes you just don’t know what questions to ask when you go to the doctor.

Some people don’t know that Medicare will pay for things like counseling for weight, depression screens, and even a free yearly wellness checkup. That isn’t simply a mistake; it’s a missed chance to find problems early, stay healthy, and save money on future medical bills.

Here’s the kicker: only 60% of those on Medicare obtained their free Annual Wellness Visit in 2022. That number went down even more in 2020, to just 45%. (CMS data)

Take a moment to think about that. Almost half of Medicare recipients aren’t taking use of one of the most fundamental advantages that are available to them.

In this post, I’ll explain what Medicare preventative services are, how they function, and what most people don’t know about them. I’ll also show you how to make sure you use all of your perks.

This isn’t just about saving money, though. It’s about staying ahead of health problems while you still have time to do something.

So let’s start by figuring out what Medicare calls a “preventive service” and why it matters more than you might believe.

What Counts as a Medicare Preventive Service? Here’s the Real Breakdown

You know how it might feel like reading a different language when you look at the list of what Medicare “covers.” Let’s get rid of the jargon.

Medicare preventive services are meant to find issues early, before they get worse or cost a lot of money. These aren’t just random visits. They are focused screenings, tests, injections, and counseling services that are based on good research.

Here is what they really include:

• This is your individualized plan for staying healthy: your annual wellness visit. It’s not a full-body physical, but it helps your doctor figure out what risks you face and how to stay healthy.
• Mammograms, colonoscopies, prostate exams, and lung cancer checks (if you qualify) are all types of cancer screenings.
• Blood pressure, cholesterol, and heart disease tests are all good for your heart health.
• Vaccines: Flu, COVID, pneumococcal, Hepatitis B, and more, depending on how likely you are to get sick.
• Mental Health: counseling for alcohol abuse and depression screens.
• Diabetes Checks: checks of blood sugar and training on how to manage diabetes on your own.
• Obesity and Nutrition Counseling: If your BMI is high, Medicare will pay for behavioral therapy to help you lose weight.

Medicare also covers several screenings that support heart disease prevention, including blood pressure checks, cholesterol tests, and counseling if you’re at risk.

And here’s the most important thing that most folks miss: If your doctor takes Medicare, a lot of these services are free. No deductible. No payment. No bill that you didn’t expect.

But—and this is important—they have to be presented as preventive. It could be “diagnostic care” if you go in for a screening and wind up getting treated for something. This can add to the expense. I’ll explain that more later in the article so you don’t get confused.

For now, simply know that Medicare doesn’t just respond. If you use it that way, it’s proactive.

A lot of people think that Medicare only starts when you get sick. But that’s not how people think anymore. You merely need to know what’s in the preventative toolbox.

Next, I’ll show you what the data reveals about how many individuals really utilize these services and why so many don’t.

Who’s Actually Using These Services? The Numbers Might Surprise You

Let’s talk about the facts.

The most recent data from CMS for 2022 shows that just roughly 6 out of 10 Medicare participants got their free Annual Wellness Visit. That means that 40% of consumers didn’t use a benefit they had already paid for. And the statistics go down even further when it comes to more specific services, like examinations for depression or screens for colorectal cancer.

Now it gets more interesting.

The National Council on Aging looked examined Medicare Advantage plans in 2020 and found that seniors on these plans were far more likely to use preventative services than seniors on Original Medicare. One big reason? Better ways to talk to each other. A lot of Advantage plans send you texts, calls, and checklists to remind you so you don’t forget.

You might not even know you’re missing out if you have Original Medicare. There is no reminder. No follow-up. No one is holding your hand.

That’s where the difference is.

Patients don’t know what Medicare offers, which is a glaring problem. And when people don’t know about it, they don’t use it. People with lower incomes, elderly folks in rural locations, and people who live alone are more likely to be affected.

In the next section, we’ll explain why so many people are not using these free services and what you can do to change that.

Why Are So Many Seniors Skipping Free Medicare Benefits?

People often forget, therefore it’s simple to think that. But the truth is more complicated.

I don’t blame seniors who don’t use their Medicare preventive services because they’re confused, misinformed, or overburdened. The Medicare system doesn’t do a very good job of making things easy.

Here are the main reasons why people miss out:

1. They Don’t Know What Is Covered

Many people believe that Medicare only covers for care after you are sick. The concept that it really pays for things like counseling on nutrition or tests for alcohol abuse? People are surprised by that. Especially since those things don’t always come up during regular appointments.

A 2022 Medicare Rights Center brief says that millions of people are qualified for complete preventative coverage but don’t know it.

2. They are worried about getting surprise bills.

Some people are afraid to make appointments for testing because they’ve heard that “free” services can end up costing them money. And they’re right—if a doctor finds something during a preventive screening and then starts treatment, the appointment might be labeled as diagnostic, and you might get a cost. People don’t come because of that ambiguous region.

3. No One Tells Them

If you have Original Medicare, you probably don’t get yearly reminders or checklists. No cards. No calls after that. You are on your own unless your provider is proactive. And let’s face it, life can become busy. This is especially true if you have additional health issues or are caring for someone else.

4. Gaps in access and fairness

Seniors in rural regions, older adults of color, and people who live below the poverty line are the least likely to get preventative care, even though they need it the most. The Office of Disease Prevention and Health Promotion has made it very apparent that where you live, what you know, and who you trust all matter.

So, no, it’s not being lazy or not caring. There are problems with communication, real-life obstacles, and not enough clear support. If you’re on a fixed income and wondering what extra help is available, check out our guide on Medicare help for low-income seniors to explore savings programs and coverage boosts.

But you can change the story if you know how these services work and how to get to them in a smart way. Confusion about what’s covered is one of the most common Medicare mistakes seniors make, and it leads to missing out on free preventive services you’ve already earned.

Next, I’ll explain the specific distinction between preventive and diagnostic care so you won’t be shocked by a bill.

Preventive vs. Diagnostic: The Billing Trap No One Warns You About

A lot of folks get caught off surprise here.

Let’s say you go in for a complimentary checkup, like a mammogram. You don’t have to pay anything if the results are clear. But the classification can change if they uncover something and need to run more tests, or if your doctor starts diagnosing or treating something during the same session.

And all of a sudden, what was “free” turns into a diagnostic visit, and you can get a fee.

This is not a hoax. That’s precisely how Medicare works. But no one truly explains it until you’ve already opened the envelope from your insurance company.

So here it is in simple terms:

• Preventive means you’re being tested even when you don’t have any symptoms. Medicare usually pays for everything.
• Diagnostic means that there is a medical cause to look into it more. Your coinsurance and deductible may now apply.

This happens a lot with:

• Colonoscopy (finding and removing a polyp)
• Checking blood pressure that leads to a new diagnosis
• Screenings that lead to follow-ups on the same day

I’m not saying you shouldn’t go; you should. But be sure you know what you’re getting into. Talk to your provider about:

• “Will this be charged as a preventive measure or a diagnosis?”
• “Will I get a separate bill if something is found?”

A brief chat upfront can prevent a lot of confusion later.

In the next part, I’ll explain why people with Medicare Advantage plans tend to do better when it comes to using preventative care. I’ll also talk about what you can learn from this even if you don’t have an Advantage plan.

Why Medicare Advantage Users Get More Preventive Care (And What You Can Learn From Them)

If you’ve ever wondered why some folks seem to know all there is to know about their Medicare benefits, it’s likely that they’re on a Medicare Advantage (MA) plan.

This Better Medicare Alliance review is only one of many studies that have demonstrated that seniors on MA plans are more likely to use preventative services than those on Original Medicare.

But why?

Here’s what Advantage plans do that other plans don’t:

1. They Push You All the Time

You’ll get calls, emails, and even text messages to remind you of your Annual Wellness Visit, flu vaccine, or mammogram. That kind of follow-up is important, especially when you have to deal with prescriptions, appointments, and everything else life throws at you.

2. They put it all together

A lot of MA plans include preventive treatments in their integrated care strategies. That means that most of the time, your tests, checks, and follow-ups are all scheduled in one spot, not at several offices.

3. They Keep an Eye on Your Gaps

They’ll let you know if you haven’t had your yearly bone density test or skipped a blood pressure test. Some even send out “scorecards” or checklists for health.

Here’s the good news: you don’t have to convert to Medicare Advantage to get the benefits of these procedures. You can borrow the book.

You can do the following even if you have Original Medicare:

• Make your own list of covered services for the year.
• Get a copy of your Medicare preventive care schedule from your doctor.
• Put reminders in your phone or calendar for yearly screenings.
• Use the Preventive Services Tool on Medicare.gov to see what you can get.

It’s not only the strategy that’s different; it’s the whole structure that goes with it. But if you have the correct plan, you can be just as informed and proactive as anyone who has an Advantage plan.

Next, we’ll show you how to make your own Medicare preventive care checklist so you never miss a benefit again.

Build Your Medicare Preventive Checklist (So You Don’t Miss a Thing)

After working with folks who are Medicare-aged for years, I’ve realized that they don’t need more knowledge; they need a system.

So, here’s how to make your own simple, personalized checklist that will help you keep up with your preventative services year after year.

Step 1: Find out what you can get

Begin with the basics. You can qualify if:

• Your age
• Your gender
• Things that put your health at danger, like smoking, diabetes, and a family history of these things

To see if you qualify, use this official Medicare.gov tool.

You may also get the whole Medicare guide as a PDF file 

Step 2: Print off this basic checklist.

Make sure you perform these things at least once a year (or as suggested):

• Wellness Visit Once a Year
• Shot for the flu
• Booster for COVID-19
• Mammogram (if you’re a woman and over 40)
• Screening for colorectal cancer (usually between the ages of 45 and 75)
• Checking for depression
• Check your blood pressure
• Checking for diabetes (if you’re at risk)
• Bone density test (for women who have gone through menopause or are at risk)

Talk to your doctor:

• “Which of these do I need to do this year?”
• “What am I missing because of my medical history?”

Step 3: Set up smart reminders

Don’t depend on your recollection. You can use a phone calendar, a caregiver, or even a piece of paper on your fridge. Choose one month each year to be your “wellness review month.” Make reservations for everything ahead of time, just like you would for an oil change or a dental cleaning.

Step 4: Keep a simple record

• Use a notebook or an app to keep track of:
• What kind of service you got
• The date
• Any follow-up or diagnostic
• Price (if any)

Why this is important: If you ever have questions about what Medicare paid for or if you’re changing providers, you can look back at your clear history.

You wouldn’t let your car run five years without getting checked out. Your body needs at least that much attention.

Next, we’ll speak about one last thing: how to talk to your doctor about preventative care without feeling rushed or ignored.

How to Talk to Your Doctor About Preventive Care (Even If You Feel Rushed)

Let’s be honest: most visits to the doctor feel short, rushed, and full with things to do. You can easily leave and realize you neglected to ask half of your queries.

You have to bring up Medicare preventative services yourself, though. Not every doctor will do this. And if they do, it might only happen once a year.

Here’s how to use your appointment time wisely without getting too stressed.

1. Use this easy opener

Begin with a solid start early in the visit:

“I want to make sure I’m taking advantage of all the Medicare preventive services I’m eligible for.” “Can we talk about that together today?”

This shows that you know what’s going on and that you want them to assist you keep ahead of health hazards instead of merely reacting to them.

2. Bring Your List

Give it to them, whether it’s from Medicare.gov or your own printout:

“This is what I’ve done this year.” Is there anything else I should know because of my age or risk factors?

This shows you’re serious and saves time. Most suppliers will be happy with it.

3. Ask About Billing Directly

To avoid surprises, ask:

“Will Medicare pay for this as a preventive service?”
“If something gets flagged, how will that change my coverage or cost?”

If your doctor’s office doesn’t know right away, ask them to check with billing before you make an appointment for tests.

4. Don’t wait for signs

This is the most important change in thinking. You don’t have to “feel sick” to go. The whole aim of preventative care is to find problems before they happen.

And what if your doctor seems to ignore it or move too quickly? That’s a sign of trouble.

You deserve a provider that cares about your long-term health, not simply the things that need to be done right away.

I’ll end with a reality check and a personal challenge to get the most out of your Medicare benefits this year in the last part.

This Isn’t Just About Checkups. It’s About Staying in Control.

The truth is that you have been paying into Medicare your whole working life. You worked hard to get these preventive advantages. But the system doesn’t just give them to you; it waits for you to ask.

And if you don’t?

The numbers speak for themselves: undetected malignancies, uncontrolled diabetes, high blood pressure, and trips to the hospital that could have been avoided. Not because they don’t care, but because they didn’t know.

So, I have a question for you:

• When did you last set up your Annual Wellness Visit?
• Are you sure you’ve had all of your screenings this year?
• Have you checked your Medicare preventive checklist in the last year?

This isn’t just a bunch of papers. This is your life, your freedom, and your chance to be healthy and at home.

You already care more than most if you’ve gotten this far in the post. Now it’s time to do something else.

• Call the number.
• Talk to your doctor about the questions.
• Use all the benefits you are entitled to without feeling guilty, confused, or delayed.

You don’t need to know a lot about Medicare. You only need a plan and a voice.

Here is your challenge: Today, make a copy of your list of preventive care. Put it on the fridge. And promise to check off every item this year.

Your future self will be grateful.

You’ve Earned These Benefits—Now Let’s Help You Use Them.

At FameTribute, we simplify Medicare so you can focus on what really matters: living well. Explore more guides, tools, and wellness tips at FameTribute.com

Disclaimer: This article is for informational purposes only and does not constitute medical, legal, or financial advice. Always consult with a licensed healthcare provider or Medicare expert before making decisions about your coverage or treatment.