Key Takeaways

• Many Medicare beneficiaries are unaware of the full range of preventive services available to them at no additional cost, leading to missed opportunities for early detection and improved health outcomes.

• As an independent agent, your ability to educate clients about Medicare-covered preventive care can improve their trust in you and help them avoid future medical complications and expenses.

Why Preventive Care Is a Medicare Priority

Preventive care isn’t just a good idea—it’s a central part of Medicare’s approach to lowering long-term healthcare costs and improving public health. Since the Affordable Care Act, Medicare has expanded coverage for a wide range of preventive services, eliminating cost-sharing for many of them. As of 2025, these services are still available without a deductible or coinsurance when delivered by providers who accept Medicare assignment.

Despite this, the majority of Medicare beneficiaries either don’t take full advantage of these services or are unaware of what’s available. That’s where you come in. You can be the person who changes how your clients think about Medicare—not just as a reactionary system for the sick, but as a proactive tool for wellness.

What Preventive Services Are Actually Free in 2025?

Medicare covers dozens of preventive services, and most clients are surprised to learn how broad this list is. Here are some of the key screenings and services that are completely covered under Original Medicare in 2025:

One-Time and Annual Visits

• “Welcome to Medicare” Visit: Available within the first 12 months of enrolling in Part B.

• Annual Wellness Visit: Can be done every 12 months after the initial Welcome Visit.

Screenings and Assessments

• Cardiovascular disease screening (every 5 years)

• Diabetes screening (up to 2 times per year if risk factors are present)

• Colorectal cancer screening (frequency depends on test type and risk profile)

• Mammograms (every 12 months for women over 40)

• Cervical and vaginal cancer screenings (every 24 months, or every 12 for high-risk individuals)

• Lung cancer screening (annually for those meeting certain criteria)

• Depression screening (annually)

• Alcohol misuse screening and counseling (annually if misuse is detected)

• Obesity screening and counseling (as needed)

• Hepatitis B and C screenings (if risk factors are present)

• HIV screening (annually if high risk or if pregnant)

Immunizations

• Flu shot (annually)

• Pneumococcal shot (1–2 times, depending on health history)

• Hepatitis B shot (for those at medium or high risk)

• COVID-19 vaccines and boosters (as recommended by the CDC)

These services do not require out-of-pocket costs if the client visits a provider who accepts Medicare.

Why Clients Still Miss These Benefits

Even though these services are available without extra cost, many clients still skip them. Here’s why:

1. Lack of Awareness

Many Medicare beneficiaries simply don’t know these services exist or assume that if something is covered, they’ll be billed later. As their agent, you can break that cycle by proactively sharing this information.

2. Misunderstanding Preventive vs. Diagnostic Care

One of the biggest sources of confusion is the difference between a preventive screening and a diagnostic test. For example:

• A routine colonoscopy is covered as preventive.

• But if a polyp is found and removed, it becomes diagnostic, and cost-sharing may apply.

Clients often feel misled when they get a bill for what they thought was a free screening. Clarifying this distinction is a critical part of your job.

3. Skipping the Annual Wellness Visit

The Annual Wellness Visit isn’t a full physical, and some clients dismiss it as unnecessary. But this visit sets the foundation for a personalized prevention plan. You can help clients see its value—not just as a box to check, but as a chance to keep tabs on their overall health and address silent risks.

4. Provider Availability and Confusion

In some areas, Medicare-accepting providers may be limited. In others, clients may not understand how to ask their provider if a service is preventive or diagnostic. Teaching clients how to confirm their provider’s participation in Medicare assignment can save them future bills and frustration.

Your Role in Closing the Preventive Care Gap

You aren’t just helping people choose a plan. You’re shaping how they engage with their healthcare for years. Here’s how you can become a reliable resource for preventive care:

Educate During Enrollment

Bring up preventive services when discussing Part B and wellness coverage. If a client has recently become eligible, emphasize the “Welcome to Medicare” visit, which must occur within the first 12 months of enrollment.

Reinforce the Annual Rhythm

Build your communication calendar around key preventive care reminders. For example:

• January: Annual Wellness Visit

• March: Diabetes Alert Day

• October: Flu season reminders

• November–December: Year-end screening wrap-up

By tying outreach to calendar events, you can stay in front of clients with timely, useful advice.

Offer Print or Email Checklists

Clients appreciate clear, tangible resources. Provide a downloadable or printable checklist of Medicare-covered preventive services. Encourage them to bring it to their next doctor’s visit and ask what they’re due for.

Be Clear About the Cost Distinction

Explain that preventive services are typically free—but that the definition matters. Diagnostic testing triggered by symptoms often comes with cost-sharing. Giving examples helps make this clearer.

Collaborate With Providers

If you maintain a network of Medicare-friendly doctors, share this with clients. A referral to the right provider makes it easier for them to act on your advice.

Preventive Care and Medicare Advantage

If your client is enrolled in a Medicare Advantage plan, the preventive benefits are required to be at least as comprehensive as Original Medicare. Some plans may offer additional services like dental cleanings or gym memberships—but that’s where the clarity needs to be even sharper.

Clients should know:

• What screenings are covered as preventive

• Whether their provider is in-network

• If there are referral or prior authorization requirements

This means your guidance must go beyond the plan brochure. Help your clients understand how to use their benefits, not just what the plan says it includes.

Timing Matters: Don’t Let Clients Miss Their Window

Some preventive benefits are time-sensitive:

• The Welcome to Medicare visit must occur within 12 months of enrolling in Part B.

• Mammograms and flu shots are annual, and spacing them matters for insurance tracking.

• Some cancer screenings have strict intervals based on age and risk factors.

Help clients avoid missing these windows by offering reminders or setting up review appointments each year.

Incentives Beyond Health: Why Clients Should Care

Preventive care doesn’t just prevent disease—it also preserves independence. Many Medicare beneficiaries fear losing mobility, cognitive function, or financial control more than illness itself. Early detection supports long-term autonomy.

By positioning preventive services as part of their broader goal—staying independent, avoiding long hospital stays, and maintaining quality of life—you make the value resonate.

Empower Clients With Confidence

You’re in a unique position to shift the conversation. When clients feel in control of their health, they become more engaged and less reactive. Preventive care is one of the most effective levers you can use to help them get there.

And the better your clients feel, the more trust they place in you.

Empowerment Begins With the Right Resources

Preventive care under Medicare is one of the most underutilized benefits available in 2025. As an independent agent, your ability to bridge that gap matters more than ever.

That’s why we created BedrockMD—to provide agents like you with training, tools, and marketing support that puts client education at the center. When you sign up, you gain access to:

• Easy-to-share educational materials

• Engagement templates tied to seasonal care

• CRM support to track client milestones and outreach

Let us help you do more than enroll. Let’s help you build lifetime value—for your clients, and your business.