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Preventive Services Checklist

Take this checklist to your doctor or other health care provider, and ask which preventive services are right for you.

You can also track your preventive services on! Get a two-year calendar of the Medicare-covered tests and screenings you’re eligible for, and print a personalized “on the go” report to take to your next doctor’s appointment.  

Medicare Covered Test/Screening/Service Date You Got This Test/Screening/Service Next Test/Screening Service Due
Abdominal Aortic Aneurysm Screening



Bone Mass Measurement         



Cardiovascular Screening



Colorectal Cancer Screening



Fecal Occult Blood Test



Flexible Sigmoidoscopy






Barium Enema     



Diabetes Screening



Diabetes Self-management Training



Flu Shot



Glaucoma Test



Hepatitis B Shot



HIV Screening






Medical Nutrition Therapy Services



Pap Test and Pelvic Exam  (includes breast exam)



“Welcome to Medicare” Preventive Visit



Yearly “Wellness” Visit



Pneumococcal Shot



Prostate Cancer Screening



Smoking Cessation Counseling



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