Preventive Care

What preventive care means

Preventive care is everything you do to stay healthy and to catch problems early. It includes routine checkups, vaccines, and screening tests that look for conditions before symptoms appear. These services lower the chance of serious illness and help you and your clinician make a plan that fits your risks and goals.

Your core Medicare preventive visits

The Welcome to Medicare preventive visit

During your first year on Part B you can get a one time visit that reviews your health history, screens for risks, and sets up needed preventive services. Many people call this the Welcome to Medicare visit. If your clinician accepts assignment you usually pay nothing.

The Yearly Wellness Visit

After your first year on Part B you can have a yearly wellness visit. It is not a head to toe physical. It is a structured check in where you and your clinician update your health history, review medications, screen for depression and safety risks, and build a personalized prevention plan with the screening schedule and vaccines you need. Your first wellness visit cannot be within twelve months of your Part B start or your Welcome to Medicare visit.

Tip Bring a list of your medicines and supplements, your home blood pressure readings if you track them, questions you want answered, and the name of a trusted contact for your care plan.

Screening tests many adults need

Screening recommendations vary by age, sex, and personal risk. A good rule is to follow grade A and B services from the United States Preventive Services Task Force and to tailor based on your history and preferences. Talk with your clinician about what fits you best.

Cancer screening

Breast cancer
Most women benefit from mammograms every other year from ages forty to seventy four. Decisions after seventy five depend on overall health and preferences.

Colorectal cancer
Adults should start screening at age forty five and continue through age seventy five using stool tests or visual tests such as colonoscopy. Between seventy six and eighty five the decision is individualized based on prior results and health status.

Prostate cancer
For many men ages fifty five to sixty nine the decision to have a prostate specific antigen blood test is a personal one after a discussion of benefits and harms. Routine screening is not recommended at age seventy and older.

Lung health
If you are fifty to eighty, have at least a twenty pack year smoking history, and currently smoke or quit within the past fifteen years, yearly low dose CT can reduce the risk of dying from lung cancer. A regular chest X ray is not recommended for lung cancer screening.

Bone health

Osteoporosis
Women sixty five and older should have a bone density scan. Younger postmenopausal women with risk factors may also need testing. Results guide nutrition, exercise, and medicines that prevent fractures.

Heart and metabolic health

Blood pressure
All adults should have their blood pressure checked. Many people forty and older benefit from yearly checks, and home or ambulatory readings are used to confirm a diagnosis.

Blood sugar
Adults thirty five to seventy who have overweight or obesity should be screened for pre-diabetes and type 2 diabetes. If you have pre-diabetes your clinician can refer you to proven preventive programs.

Cholesterol and statins
Adults forty to seventy five with one or more cardiovascular risk factors may benefit from a statin for prevention based on their calculated ten year risk. Decide with your clinician after reviewing your numbers and preferences.

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Vaccines that protect adults

Staying up to date on vaccines prevents illness and hospital stays. Your clinician will tailor the schedule to your age and health conditions, using the current adult immunization schedule.

What many adults need

• Flu vaccine every year
• Updated COVID vaccine when recommended
• Tdap or Td boosters as directed
• Shingles vaccination with two doses of Shingrix starting at age fifty
• Pneumococcal vaccination for adults fifty and older as indicated and for all adults sixty five and older following current options such as PCV20 or PCV21 with schedules based on past vaccines

Safety and daily life check ins

Falls are common and can be serious for older adults. Screening for fall risk, medication review, vision checks, home safety, and balance and strength exercises lower the chance of injury.

Everyday steps to lower risk

• ‍‍Review medicines that can cause dizziness or sleepiness
• Get your eyes checked and update your glasses
• Ask about a balance and strength program that fits your abilities
• Use assistive devices that help with walking and transfers when needed
• Make home changes such as removing loose rugs, adding grab bars, and improving lighting

If mobility equipment would help you stay independent, see Understood Care’s page on Mobility Equipment Support at https://understoodcare.com/care-types/mobility-equipment. If rides are the barrier, our Transportation Help page is here: https://understoodcare.com/care-types/transportation-help

How an advocate helps you actually get preventive care done

Amanda from Understood Care said it best in her video. Preventive care works when someone helps you connect the dots.

Here is what our advocates can do for you

• ‍‍Contact your primary care or specialist to confirm where the order was sent for your mammogram, bone density scan, colonoscopy, prostate lab, or lung CT
• Verify that the imaging center or clinic received the order and that it is legible and complete
• Check whether authorizations are needed and obtain them when required
• Call the facility to confirm earliest appointments and place you on a cancellation list if you want something sooner
• Do a three way call so you hear everything directly and can ask questions
• Schedule the appointment while you are on the line whenever possible
• Help you plan transportation and access needs for the day of your test
• Remind you about prep steps such as bowel prep for colonoscopy or removing metal before a bone density scan
• Follow up to make sure results reach your clinician and that you understand next steps

If transportation, mobility, or preparation is stressing you, an advocate can make those calls and get you scheduled so you stay safe and healthy, just like Amanda described

What Medicare usually covers for preventive care

Medicare Part B covers a wide range of preventive services such as the Welcome to Medicare visit, the yearly wellness visit, many vaccines, and screenings like colorectal cancer tests. Your costs can change if additional diagnostic testing is done during the same visit, so ask what will be billed as preventive versus diagnostic. To see examples of covered services, review the Medicare preventive and screening services list.

How to prepare for common screenings

Mammogram‍

• Wear a two piece outfit
• Avoid deodorant or powders on exam day
• Bring prior images if you are going to a new facility
• Tell the technologist about implants or surgeries

Colonoscopy

• Follow the exact prep instructions
• Plan a ride home and time to rest that day
• Ask about stool based alternatives if you prefer a noninvasive option and are average risk

Bone density scan

• ‍‍Avoid calcium supplements for twenty four hours before the test unless you were told otherwise
• Wear clothing without metal

Lung cancer low dose CT

• ‍‍Confirm you meet eligibility
• Schedule a shared decision making visit if your center requires it

Prostate screening

• ‍‍Plan a short conversation with your clinician about your values and preferences before ordering a PSA test

When to contact Understood Care

If your clinician ordered a mammogram, bone density scan, colonoscopy, prostate screening, or a low dose CT and you are not hearing back, we can make the calls for you. We verify orders, secure authorizations, and get you on the schedule. We can also do a conference call with you so you hear everything in real time and can give consent or ask questions on the spot. If you want help now, visit our Transportation Help or Mobility Equipment pages above to get started.

Preventive Care and Medicare: Frequently Asked Questions

• What is preventive care and why does it matter?
  Preventive care includes everything you and your clinician do to keep you healthy and catch problems early. It covers routine checkups, vaccines, and screening tests that look for conditions before symptoms appear. These services reduce the risk of serious illness and help you create a plan that fits your personal risks and goals.
• What is the Welcome to Medicare preventive visit?
  During your first year on Part B you can have a one time Welcome to Medicare visit. At this visit your clinician reviews your medical and family history, checks your current health, screens for key risks, and maps out which preventive services you need. If your clinician accepts assignment you usually pay nothing.
• What is the yearly Medicare wellness visit and how is it different from a physical?
  After your first year on Part B you can have a yearly wellness visit. It is not a full head to toe physical. Instead it is a structured check in where you and your clinician update your health history and medication list, screen for depression and safety risks, and build a personalized prevention plan with recommended screenings and vaccines. Your first wellness visit must be at least twelve months after your Part B start or your Welcome to Medicare visit.
• How should I prepare for a wellness or preventive visit?
  Bring a written list of all medicines and supplements you take, including doses and timing. Bring home blood pressure readings if you track them. Write down your questions and concerns in advance. Have the name and contact information of a trusted person you want included in your care plan.
• Which cancer screenings do most adults need to discuss?
  Most women ages forty to seventy four benefit from mammograms every other year. Adults should start colorectal cancer screening at forty five and continue through seventy five using stool based tests or colonoscopy and other visual tests. Men ages fifty five to sixty nine may choose prostate specific antigen blood testing after a balanced discussion of benefits and harms, and routine screening is generally not advised at seventy and older. People fifty to eighty with a significant smoking history and who currently smoke or quit within the last fifteen years may qualify for yearly low dose CT lung scans.
• Why is bone density screening important?
  Bone density scans check for osteoporosis, which weakens bones and increases fracture risk. Women sixty five and older should have a scan, and younger postmenopausal women with risk factors may also need testing. Results guide decisions about calcium, vitamin D, exercise, and medicines that protect bone strength.
• What screenings support heart and metabolic health?
  Everyone should have blood pressure checked regularly, with many adults forty and older needing yearly checks or home monitoring. Adults thirty five to seventy with overweight or obesity should be screened for pre diabetes and type 2 diabetes. Adults forty to seventy five with risk factors such as high blood pressure, smoking, or diabetes may benefit from a statin medicine to lower cardiovascular risk. These decisions are made with your clinician after reviewing your numbers and preferences.
• Which vaccines are most important for adults to keep current?
  Most adults need a flu shot every year, updated COVID vaccination when recommended, tetanus and diphtheria boosters with at least one Tdap dose, shingles vaccination with two doses of Shingrix starting at age fifty, and pneumococcal vaccination as indicated for adults fifty and older and for all adults sixty five and older following the current schedule such as PCV20 or PCV21. Your clinician will tailor timing based on your age, health conditions, and prior vaccine history.
• How does preventive care address fall risk and daily safety?
  Preventive care includes checking for fall risk, reviewing medicines that affect balance, screening vision, and discussing home safety. Strength and balance exercises, vision care, assistive devices, and simple home changes such as removing loose rugs, adding grab bars, and improving lighting all lower the chance of serious injury. If you need mobility equipment to stay independent, Understood Care’s Mobility Equipment Support page can help. If transportation is a barrier, the Transportation Help page is available.
• How does an Understood Care advocate help me actually complete screenings and tests?
  Advocates help you move from orders to completed care. They confirm where your clinician sent the order for tests like mammograms, bone density scans, colonoscopies, prostate labs, or lung CTs. They verify that the imaging center or clinic received the order and that authorizations are in place when required. They call facilities to find the earliest appointments, request cancellation list spots if you want something sooner, and can set up three way calls so you hear everything and ask questions directly. Advocates also help plan transportation, remind you about preparation steps, and follow up to ensure results reach your clinician and that you understand the next steps.
• What preventive services does Medicare usually cover?
  Medicare Part B covers many preventive services at little or no cost when rules are met. These include the Welcome to Medicare preventive visit, yearly wellness visits, many vaccines, and screening tests such as colorectal cancer screening, mammograms, bone density scans, and certain cardiovascular screenings. If additional diagnostic tests or treatments are done during the same visit, you may have a copay or coinsurance, so it is helpful to ask which parts will be billed as preventive and which as diagnostic.
• How should I prepare for a mammogram?
  Wear a two piece outfit so you only need to undress from the waist up. Avoid deodorant, powders, or lotions on your chest or underarms on exam day, as they can affect the images. If you are going to a new facility, bring information about prior mammograms so images can be compared. Tell the technologist about any implants, prior surgeries, or breast problems.
• What should I know before a colonoscopy or other colorectal screening?
  For colonoscopy, follow the bowel prep instructions exactly, since a clean bowel is essential for a good exam. Arrange a ride home because you will usually receive sedation and should not drive afterward. Plan time to rest that day. If you are average risk and prefer a noninvasive option, ask your clinician about stool based tests and how often they should be repeated.
• How do I get ready for a bone density scan?
  Avoid taking calcium supplements for twenty four hours before the test unless your clinician tells you otherwise. Wear comfortable clothing without metal zippers, belts, or buttons in the area to be scanned. The test is painless and quick and does not require sedation.
• What is involved in lung cancer screening with low dose CT?
  If you are between fifty and eighty with a qualifying smoking history, your clinician may refer you for yearly low dose CT. Many centers ask you to have a shared decision making visit to review benefits, risks, and follow up plans before starting. During the scan you lie still on a table that moves through the CT machine. The test is brief and does not require injections for standard screening.
• How is prostate cancer screening decided?
  Prostate screening with a PSA blood test is a preference sensitive decision for many men ages fifty five to sixty nine. Your clinician should review possible benefits, false alarms, and potential harms such as overdiagnosis and treatment side effects. After that conversation, you can decide together whether to test and how often to repeat it.
• When should I contact Understood Care for help with preventive care?
  Reach out if your clinician has ordered a mammogram, bone density scan, colonoscopy, prostate screening, or low dose CT and you are not hearing back about scheduling. Understood Care can verify orders, clarify authorizations, coordinate transportation, and arrange conference calls so you can give consent and ask questions directly. You can also contact the team if mobility, preparation, or logistics are making it hard to complete preventive care, or if you need help with equipment or rides through the Mobility Equipment Support and Transportation Help pages.

References

• United States Preventive Services Task Force. A and B Recommendations. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
• United States Preventive Services Task Force. Breast Cancer Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
• United States Preventive Services Task Force. Colorectal Cancer Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• United States Preventive Services Task Force. Prostate Cancer Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
• United States Preventive Services Task Force. Lung Cancer Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
• United States Preventive Services Task Force. Osteoporosis to Prevent Fractures Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening
• United States Preventive Services Task Force. Hypertension in Adults Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening
• United States Preventive Services Task Force. Prediabetes and Type 2 Diabetes Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes
• United States Preventive Services Task Force. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication
• Centers for Disease Control and Prevention. Immunization Schedules for Adults. https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html
• Centers for Disease Control and Prevention. Shingles Vaccination. https://www.cdc.gov/shingles/vaccines/index.html
• Centers for Disease Control and Prevention. Pneumococcal Vaccine Recommendations. https://www.cdc.gov/pneumococcal/hcp/vaccine-recommendations/index.html
• Centers for Disease Control and Prevention. Facts About Falls in Older Adults. https://www.cdc.gov/falls/data-research/facts-stats/index.html
• Medicare. Preventive and Screening Services. https://www.medicare.gov/coverage/preventive-screening-services
• Medicare. Welcome to Medicare Preventive Visit. https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit
• Medicare. Yearly Wellness Visits. https://www.medicare.gov/coverage/yearly-wellness-visits
• MedlinePlus. Preventive Health Care. https://medlineplus.gov/ency/article/001921.htm
• Cleveland Clinic. Prophylaxis and Preventive Care. https://my.clevelandclinic.org/health/articles/prophylaxis-preventive-care

This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.