Retirement checklist for your body: 8 screenings to book in the first year

The first year after you stop working has a strange shape. The calendar is emptier than it has been since you were 22, yet the one set of appointments that changes how the next 20 years go tends not to get booked. Nobody at work is nagging you about the health fair. The Medicare card arrives, gets filed, and that is that.

This is the list I would hand a friend on their 65th birthday: eight appointments, one year, in an order that makes sense. For each, what it catches, how often, and what it costs under Medicare Part B. Most cost nothing if your provider accepts assignment, which is the quiet good news here.

Plus two items that are not screenings but belong on the same page: dental, and a ten-minute strength baseline.

Start with the visit that sets the calendar

1. The "Welcome to Medicare" visit, then the yearly wellness visit. In your first 12 months with Part B you get a one-time preventive visit: blood pressure, weight, a medication and family-history review, a depression screen and, crucially, a written schedule of which screenings and shots you are due. After that, the Annual Wellness Visit does the same job once every 12 months. Both are free with a provider who accepts assignment. Book this first; it books the rest. Bring every pill bottle and supplement in a bag.

The checklist, in the order that makes sense

The fine print

Blood pressure. The US Preventive Services Task Force gives blood pressure screening its strongest grade and adds one detail: confirm a high office reading with measurements outside the office before starting treatment. That is the case for owning an upper-arm cuff. Medicare's diabetes screen is free up to twice a year if you have a risk factor such as high blood pressure, being overweight or a family history, which covers most people at 65.

Colorectal. USPSTF recommends screening from 45 to 75, and a selective call from 76 to 85. Colonoscopy every ten years and a yearly FIT stool test are both fully accepted; the best test is the one you will actually do. Medicare covers the screening colonoscopy every 120 months (every 24 if high risk) at no cost. If a polyp is removed, you owe 15% coinsurance, but the Part B deductible does not apply.

Bone density. USPSTF recommends a DXA scan for all women 65 and older. For men the evidence is rated insufficient, which is not the same as "men don't need it": long-term steroid use, a prior low-trauma fracture, low testosterone or heavy drinking are reasons to ask. Medicare pays every 24 months when one of its criteria applies; estrogen deficiency with clinical risk covers most women at 65.

Eyes. Original Medicare does not pay for a routine eye exam or glasses. It covers a yearly glaucoma test if you have diabetes, a family history, or are African American and 50-plus or Hispanic and 65-plus, and a yearly diabetic eye exam, both at 20% after the deductible. Everyone else pays cash, typically $100 to $200. Cataract surgery is covered.

Vaccines. The CDC schedule for 65 and older: Shingrix, two doses two to six months apart; one pneumococcal conjugate dose (PCV20 or PCV21), or PCV15 followed by PPSV23; a flu shot every fall, high-dose or adjuvanted preferred; the current season's COVID-19 vaccine; Tdap if you never had one, then a booster every ten years; and a one-time RSV vaccine from 75, or from 60 with heart or lung disease. Flu, pneumococcal and COVID-19 are free under Part B. Shingrix, Tdap and RSV run through Part D and have been $0 there since 2023.

What the evidence says about hearing

Hearing is the item most people skip and the one with the most interesting data. In a Johns Hopkins study published in 2011, 639 adults had their hearing tested and were followed for roughly 12 years. Dementia risk rose with the degree of loss: about double with mild loss, triple with moderate, nearly fivefold with severe, after adjusting for age, diabetes and blood pressure.

That was an association, so the same group ran a trial. ACHIEVE, published in The Lancet in 2023, randomized 977 adults aged 70 to 84 with untreated hearing loss to hearing aids plus counseling or to a health-education program for three years. Across everyone, cognitive decline was not significantly different. But in the subgroup drawn from an existing heart-health cohort, older and at higher risk, the hearing intervention slowed decline by 48%.

The honest summary: get the baseline now, and if you have loss, treat it. Since 2023 Medicare lets you see an audiologist once every 12 months without a doctor's order. The aids themselves are not covered; over-the-counter models start around $200 to $300 a pair.

Where the evidence stops

Whole-body skin screening. USPSTF finds insufficient evidence for or against a routine full-body skin exam in adults with no symptoms. Melanoma is more common and more often fatal in men over 50, so a one-time dermatology visit is reasonable if you are fair, have many moles, had blistering sunburns or a prior skin cancer. For everyone else the supported move is cheaper: know your skin and show your clinician anything new, changing or not healing.

Tests not on this list. PSA screening after 70 is not recommended by USPSTF. Routine vitamin D blood tests, full-body MRIs and "executive physicals" sound thorough, have no evidence of improving outcomes, and generate follow-ups. And the strength numbers below are a baseline, not a diagnosis; a low score is a reason to start lifting and mention it at your wellness visit.

The ten-minute strength baseline

Muscle loss is the one big age-related change no screening above catches, and the most reversible. Two tests, repeated the same way each year.

Grip strength. In the PURE study, which followed nearly 140,000 adults in 17 countries, every 5 kg (11 lb) less grip strength was associated with a 16% higher risk of death from any cause, and grip predicted mortality better than blood pressure did. Squeeze a digital dynamometer three times per hand, elbow at 90 degrees, and record the best number.

The 30-second chair stand. This is the test in the CDC's fall-prevention toolkit. Sit in the middle of a sturdy armless chair, cross your arms over your chest, and count full stand-and-sits in 30 seconds. CDC flags fewer than 12 for men and fewer than 11 for women aged 65 to 69 as below average and a marker of fall risk. Two sessions a week of sit-to-stands and light weights usually moves that number within a couple of months.

Four things worth buying this year

What to book this month

• Book the Welcome to Medicare visit, or the Annual Wellness Visit if you are past month 12. Bring every bottle.
• Leave that visit with dates for the lipid panel, A1c, DXA and your colorectal screening choice.
• Book a baseline hearing test and a dilated eye exam yourself; nobody will order them for you.
• Get Shingrix dose one and this season's flu shot at the pharmacy, and set a reminder for dose two.
• Do the chair-stand test today, write the number inside a kitchen cabinet, repeat next birthday.