Medicare plans FAQs

When you receive preventive care, you won't have a copay. During that visit, if you also receive care that's not considered preventive care, then a copay will be charged. For example: If you go to your doctor for a seasonal flu shot and an annual wellness visit, you wouldn't have a copay because these are preventive care services. If during the same visit, you tell your doctor about a condition that requires an X-ray or you ask to have a skin tag removed, you would have a copay for those two services. That's because the X-ray is used to diagnose and the skin tag removal is a separate procedure, neither of which are considered preventive care. It's helpful to know what types of care are considered preventive. Preventive care includes:

• An annual wellness visit that is a comprehensive, preventive medicine evaluation that results in a prevention plan based on your needs
• Services to help you avoid illness or injury, including flu shots or pneumonia vaccines
• Tests and screenings to detect undiagnosed diseases or problems, including routine cancer screenings, such as mammograms

Preventive care does not include:

• Diagnosis or monitoring of a problem or symptom you already have
• Treatment of pain or other symptoms of an illness or disease
• Treatment of problems found during a preventive care appointment

Sign in to see your specific plan benefits. Or find your Medicare plan and refer to your plan documents for Evidence of Coverage.

How can I find my benefits?
Sign In to see your specific plan benefits. Or find your Medicare plan documents and review your benefit coverage details.

Plan documents for Medica Advantage Solution^® members
Plan documents for Medica Prime Solution ^® members