Starting in 2026, Medicare and Medicaid are offering free health check-ups for Americans aged 40 to 74. The move aims to improve early detection of health issues and promote preventive care. Here's what you need to know about this new program, its coverage, and what it means for millions of beneficiaries across the country.

Key Figures at a Glance

  • Free annual health check-ups available for Medicare and Medicaid beneficiaries aged 40-74 starting January 1, 2026.
  • The check-ups include risk assessments, screenings for chronic conditions, lab tests, and personalized health advice without any co-pays or deductibles.
  • Elevance Health, a leading managed care organization, serves approximately 47 million members nationwide, highlighting the scale of coverage affected by this program.
  • Medicaid funding is projected to face cuts under the One Big Beautiful Bill Act of 2025, with an estimated $5 billion reduction in federal funding over the next five years, potentially impacting enrollment and service delivery.
  • Centene Corporation and other insurers have launched social initiatives, including affordable housing programs and nutrition support, aiming to address social determinants of health alongside medical care.
  • In fiscal year 2025, Elevance Health reported revenues of $49.31 billion, marking a 9.6% increase from $44.96 billion in 2024, driven in part by expanded preventive care services.
  • Despite revenue growth, average stock prices of major health insurers dropped 16.3% following Q4 2025 earnings reports, reflecting market volatility and investor concerns over rising medical inflation.
  • Regulatory scrutiny has intensified, with the Centers for Medicare & Medicaid Services (CMS) increasing oversight on claims and reimbursements, impacting insurer operations and beneficiary experiences.
  • Preventive screening services aim to reduce long-term healthcare costs by identifying conditions like hypertension, type 2 diabetes, colorectal and breast cancer at earlier, more treatable stages.
  • States that expanded Medicaid under the Affordable Care Act show higher participation rates in the free check-up program, with some states reporting up to 70% uptake among eligible enrollees compared to less than 40% in non-expansion states.

Overview of Medicare/Medicaid Health Check in 2026

Starting January 1, 2026, Medicare and Medicaid beneficiaries aged 40 through 74 gain access to free annual health check-ups. This program is designed to identify early signs of chronic diseases, which are prevalent in this age group, and provide personalized preventive care plans. The check-ups include comprehensive risk assessments covering cardiovascular health, metabolic conditions, cancer screenings, and mental health evaluations.

Eligible beneficiaries pay no co-pays, deductibles, or other out-of-pocket costs for these services, making preventive care more accessible. The program also covers laboratory tests such as lipid profiles, blood glucose levels, and complete blood counts. Healthcare providers use the results to tailor advice on lifestyle changes, medication management, and referrals for further treatment if necessary.

Managed care organizations like Elevance Health play a crucial role in coordinating these services. Elevance Health, which serves 47 million members, has expanded its provider network and invested in digital health tools to support remote monitoring and follow-ups.

The company’s 2025 financial reports show a 9.6% year-over-year revenue increase to $49.31 billion, partly due to increased preventive care utilization.

Medicaid’s inclusion of the free check-up aligns with ongoing efforts to reduce disparities in healthcare access. Yet, the program’s success depends on state-level implementation.

States that expanded Medicaid under the Affordable Care Act report higher beneficiary engagement in preventive services, with uptake averaging 65% compared to 38% in states without expansion as of late 2025.

Comparing Medicare and Medicaid Options

Both Medicare and Medicaid cover the new annual check-up, but there are differences in how services are delivered and accessed. Medicare beneficiaries primarily receive these services through traditional fee-for-service plans or Medicare Advantage plans, which often include extra benefits such as wellness coaching and transportation assistance.

Medicaid coverage varies by state due to differing eligibility criteria and managed care arrangements. In expansion states, Medicaid enrollees have broader access to primary care providers and community health programs that support preventive care. Conversely, non-expansion states may face provider shortages and limited program outreach, reducing check-up participation.

Cost-sharing is generally prohibited for these check-ups under both programs, but Medicaid enrollees may face barriers like transportation challenges or lack of provider availability, especially in rural areas. To address these issues, insurers like Centene have invested in social determinants of health programs, including partnerships with housing organizations and food banks, to improve overall health outcomes.

Data from 2025 shows Medicare Advantage plans reporting a 55% screening rate for eligible beneficiaries, while Medicaid managed care plans in expansion states report rates closer to 60%. Non-expansion Medicaid states lag behind with rates near 35%, underscoring the importance of state policy on preventive healthcare access.

Regional Differences and Impact of Medicaid Expansion

Access to the free health check-ups in 2026 varies significantly by region. The 39 states plus Washington D.C. That expanded Medicaid under the Affordable Care Act have greater infrastructure and funding to support preventive care. These states see higher engagement rates, with some like California and New York reporting over 70% of eligible Medicaid beneficiaries completing their annual check-up.

In contrast, states that didn't expand Medicaid—mostly in the South and parts of the Midwest—face lower participation rates. These states often have higher uninsured rates and fewer providers accepting Medicaid, limiting access. For example, Texas and Florida report less than 40% uptake among eligible Medicaid enrollees.

Rural areas face additional challenges. According to 2025 data, only 30% of eligible rural Medicaid beneficiaries received their free annual check-up, compared to 58% in urban areas. Transportation issues, provider shortages, and digital access disparities contribute to this gap.

The One Big Beautiful Bill Act passed in late 2025 includes federal Medicaid funding cuts projected at $5 billion over five years. These cuts may reduce state budgets for outreach and preventive programs, potentially lowering participation in free check-ups.

States heavily reliant on federal Medicaid funds could see service disruptions starting in 2027.

Forecast and Outlook for Medicare/Medicaid Preventive Care

Looking ahead, the free annual health check-up program will probably expand its reach. CMS projects a 15% increase in beneficiary participation by 2028, driven by enhanced provider networks and digital health tools like telehealth consultations and remote monitoring.

Health insurers are investing in social programs to address non-medical barriers. Centene’s affordable housing initiatives, launched in 2025, aim to reduce hospitalization rates by 10% over three years among participating members. Similarly, Elevance Health plans to increase spending on community health workers by 20% in 2026 to support preventive care adherence.

However, challenges remain. Inflation in medical costs—estimated at 6.5% annually—continues to pressure insurer margins and may affect service availability.

Regulatory scrutiny is also rising, with CMS implementing stricter audits on preventive care claims starting mid-2026. That could slow reimbursement processes and impact provider participation.

Despite these hurdles, the emphasis on early detection and preventive care is likely to reduce long-term healthcare costs. Studies estimate that effective preventive screenings could lower Medicare and Medicaid expenditures by up to $3 billion annually by 2030 due to fewer hospital admissions and advanced disease treatments.

Free health check-ups under Medicare and Medicaid for 40 to 74-year-olds in 2026 mark a big shift toward preventive care. But the impact will vary widely depending on state policies, funding availability, and insurer initiatives. With Medicaid funding cuts looming and regional disparities persisting, the program's success depends on ongoing investments in access and outreach. Still, early data suggests these check-ups could help millions catch health problems sooner and reduce costly treatments down the road.