Here’s something most people don’t think about until it’s too late: the conditions most likely to cause serious problems after 65 — high blood pressure, diabetes, colorectal cancer, osteoporosis — often produce zero symptoms in their early stages. You feel fine. Everything seems normal. Then one day a routine blood test catches something that’s been quietly progressing for years.
That’s why preventive screenings matter so much after 65. They’re not about looking for trouble — they’re about catching problems when they’re still small and treatable. A blood pressure reading that catches stage 1 hypertension. A colonoscopy that finds a polyp before it becomes cancer. A bone density scan that reveals osteoporosis before a fall turns into a broken hip.
We put this guide together to give you a clear, age-by-age breakdown of what tests to get and when. We also looked into exactly what Medicare covers (most of these screenings are free under Part B) so you know what to expect at your next appointment. Questions we didn’t answer? Reach out at [email protected] — we’ll get back to you.
The Medicare Annual Wellness Visit
Before we get into specific screenings, let’s talk about the single most important appointment on your calendar: the Medicare Annual Wellness Visit (AWV). This is different from a regular physical exam. During the AWV, your doctor creates or updates a personalized prevention plan based on your health history, current conditions, and risk factors.
The AWV is covered at 100% under Medicare Part B — no copay, no deductible. During this visit, your doctor will:
- Review your medical and family history
- Check your height, weight, blood pressure, and BMI
- Screen for depression and cognitive impairment
- Update your list of current medications and providers
- Create a screening schedule tailored to your specific risks
- Assess your fall risk
This visit is your annual chance to ask questions, flag new symptoms, and make sure you’re on track with every screening that matters. If you’re not already scheduling one every year, start this year.
Screenings for Ages 65 to 69
This is the period when most people are new to Medicare and should establish a solid baseline. Your body is changing in ways you may not notice, and early detection during these years pays off for decades.
Blood Pressure
How often: At every doctor visit, at minimum once per year What it checks: Risk of heart attack, stroke, kidney disease Medicare coverage: Fully covered as part of your wellness visit
High blood pressure affects nearly 70% of adults over 65. It has no symptoms until it causes serious damage. The target for most seniors is below 130/80, though your doctor may adjust that based on your overall health.
Cholesterol (Lipid Panel)
How often: Every 1-2 years, or more frequently if levels are elevated What it checks: LDL, HDL, triglycerides — all tied to cardiovascular risk Medicare coverage: Covered every 5 years; more frequent testing may require a diagnosis code
A full lipid panel takes a simple blood draw. If your LDL cholesterol is above 130 mg/dL or you have other cardiac risk factors, your doctor will likely want to check it annually.
Colorectal Cancer Screening
How often: Colonoscopy every 10 years, or stool-based test (FIT) annually What it checks: Polyps and early-stage colorectal cancer Medicare coverage: Colonoscopy covered every 10 years (every 2 years for high risk); FIT test covered annually
Colorectal cancer is the third most common cancer in the U.S. and one of the most preventable through screening. If you haven’t had a colonoscopy yet, now is the time. The prep is unpleasant, but the test itself is painless — and it can save your life.
Mammogram (Women)
How often: Every 1-2 years What it checks: Breast cancer Medicare coverage: Covered every 12 months for women 40+
Breast cancer risk increases with age. Medicare covers one screening mammogram every 12 months. If you have a family history of breast cancer or carry certain genetic mutations, talk to your doctor about whether more frequent screening or additional imaging (like breast MRI) makes sense.
Diabetes Screening
How often: Every 3 years, or annually if you have risk factors What it checks: Blood sugar levels, prediabetes, type 2 diabetes Medicare coverage: Covered for those at risk (overweight, family history, history of gestational diabetes)
About 25% of adults over 65 have diabetes, and many don’t know it. A fasting blood glucose or A1C test during your annual blood work catches it early. If you’re prediabetic, lifestyle changes at this stage can actually reverse the trajectory.
Bone Density (DEXA Scan)
How often: Every 2 years for women; for men with risk factors What it checks: Osteoporosis and fracture risk Medicare coverage: Covered every 24 months for women 65+ and high-risk individuals
One in three women and one in five men over 50 will experience an osteoporotic fracture. A DEXA scan is painless, takes about 10 minutes, and gives you a clear picture of your bone health. If your score indicates osteoporosis, early treatment with medication and weight-bearing exercise can significantly reduce fracture risk.
Screenings for Ages 70 to 74
By your early 70s, you should have solid baselines for most conditions. Now the focus shifts to maintaining those baselines and adding screenings for age-related changes that accelerate during this decade.
Vision Exam
How often: Every 1-2 years What it checks: Glaucoma, macular degeneration, cataracts, diabetic retinopathy Medicare coverage: Glaucoma test covered every 12 months for high-risk individuals; diabetic eye exams covered annually
Age-related macular degeneration affects about 11 million Americans, and glaucoma often has no symptoms until vision loss is permanent. A dilated eye exam catches both. If you have diabetes, annual diabetic eye exams are essential — diabetic retinopathy is the leading cause of blindness in adults.
Hearing Test
How often: Every 1-3 years What it checks: Age-related hearing loss Medicare coverage: Diagnostic hearing exams covered when ordered by a doctor; routine hearing tests are NOT covered under Original Medicare
About one in three people between 65 and 74 has some degree of hearing loss. Left untreated, it’s linked to faster cognitive decline, depression, and social isolation. While Medicare doesn’t cover routine hearing tests, your doctor can order a diagnostic exam if they suspect hearing loss during your wellness visit.
Skin Cancer Check
How often: Annually, or as recommended by your dermatologist What it checks: Melanoma, basal cell carcinoma, squamous cell carcinoma Medicare coverage: Covered when medically necessary (suspicious moles, history of skin cancer)
The risk of melanoma increases significantly after 65. Men over 65 have the highest rate of melanoma diagnosis of any demographic group. A full-body skin exam takes about 15 minutes. Point out any new moles, spots that have changed color or shape, or sores that won’t heal.
Cognitive Assessment
How often: Annually as part of the Medicare Annual Wellness Visit What it checks: Early signs of memory loss, dementia, Alzheimer’s disease Medicare coverage: Included in the Annual Wellness Visit at no cost
Starting at 70, cognitive assessments become especially valuable. The screening is brief — your doctor may ask you to remember a short list of words, draw a clock, or answer orientation questions. These aren’t diagnostic on their own, but they create a year-over-year record that helps spot subtle changes early.
Screenings for Ages 75 to 79
After 75, screening decisions become more individualized. Your doctor will weigh the benefits of certain tests against your overall health, life expectancy, and personal preferences. Some screenings may be discontinued; others become more important.
Continuing Screenings
Most of the tests above should continue on schedule: blood pressure at every visit, cholesterol every 1-2 years, diabetes screening as needed, vision exams, hearing tests, cognitive assessments, and skin checks. Your annual wellness visit remains the anchor for all of these.
Colorectal Cancer Screening
The U.S. Preventive Services Task Force recommends colorectal cancer screening through age 75 for everyone, and from 76-85 on an individual basis depending on health and prior screening history. If you’ve been getting regular colonoscopies with clean results, your doctor may recommend switching to annual stool-based tests instead.
Prostate Cancer Screening (Men)
How often: Discuss with your doctor What it checks: PSA levels and prostate cancer risk Medicare coverage: PSA test covered annually for men 50+
After 75, the decision to screen for prostate cancer is a conversation, not an automatic test. Many prostate cancers grow slowly and may never cause problems during a man’s lifetime. Your doctor will consider your overall health, family history, and prior PSA results to decide whether continued screening makes sense.
Fall Risk Assessment
How often: Annually What it checks: Balance, gait, medication side effects, home safety risks Medicare coverage: Included in the Annual Wellness Visit
Falls are the leading cause of injury-related death among adults 65 and older, and the risk increases sharply after 75. Your doctor should assess your fall risk annually and may refer you to physical therapy for balance training or recommend home modifications.
Screenings After 80
After 80, quality of life takes center stage. Screenings shift toward maintaining function, managing existing conditions, and preventing acute events like falls and medication errors.
What Continues
- Blood pressure monitoring at every visit
- Diabetes management and A1C monitoring for those with diabetes
- Annual wellness visit with cognitive assessment
- Vision and hearing exams
- Fall risk assessment (becomes increasingly critical)
- Medication review to identify interactions and side effects
What May Be Discontinued
Your doctor may recommend stopping certain cancer screenings after 80 if the risks of the procedure (or treatment of slow-growing cancers) outweigh the benefits. This is a personal decision based on your overall health, and it’s worth having an honest conversation with your doctor about what makes sense for you.
Medication Review
This isn’t a screening in the traditional sense, but it’s one of the most important things your doctor can do after 80. The average senior takes 5 or more prescription medications. Drug interactions, side effects like dizziness or confusion, and outdated prescriptions contribute to falls, hospitalizations, and cognitive decline. Ask your doctor to review every medication — prescription and over-the-counter — at each visit.
What to Ask Your Doctor
Going into your next appointment, bring these questions:
- Am I up to date on all recommended screenings for my age?
- Are there any screenings I should stop based on my current health?
- Could any of my medications be causing symptoms I’ve attributed to aging?
- What’s my fall risk, and what can I do to reduce it?
- Should I be referred to any specialists (cardiologist, ophthalmologist, audiologist)?
- Are there screenings I should get more often based on my family history?
Write your questions down beforehand. Appointments go fast, and it’s easy to forget what you wanted to ask once you’re in the exam room.
Staying on Top of Your Schedule
The easiest way to keep track of your screening schedule is to use your Medicare Annual Wellness Visit as the starting point each year. During that visit, your doctor will update your personalized prevention plan and tell you exactly what’s due. Keep a copy of that plan and schedule your follow-up appointments before you leave the office.
Medicare covers more preventive services than most people realize — and the vast majority of these screenings cost you nothing under Part B. Taking advantage of them is one of the smartest things you can do for your health after 65.
If you have questions about what Medicare covers or need help finding a provider, drop us a line at [email protected]. We’re real people and we’ll point you in the right direction.