Frequency Limits
Many Medicare preventive services have frequency limits, meaning Medicare covers them only as often as allowed (for example, once every 12 months, once every five years, or once in your lifetime). The schedule varies by service.
Why it Matters
If you get a service too soon, Medicare may not pay, even if it’s medically reasonable. Also, “12 months” and “calendar year” can be different in Medicare terms, which can affect timing.
Action Steps
Ask: “How often does Medicare cover this, and when was my last one?”
Keep a simple prevention tracker (date + result + next due date).
If you’re close to the limit, ask the provider to confirm timing before ordering the service.
For Medicare Advantage, confirm whether the plan follows the same schedule and whether prior auth is required.