The AAA talk · Screenings by age
The One-Time Ultrasound Some Men Should Discuss at 65
At 65, a one-time abdominal aortic aneurysm ultrasound is recommended for men who ever smoked. Here is how it fits with Medicare.
Men ages 65 to 75 who have ever smoked should have a one-time abdominal aortic aneurysm ultrasound. Men in the same age range who never smoked can be selectively offered the test. It is quick, noninvasive, and usually covered when eligibility conditions are met.
Who needs AAA screening
An abdominal aortic aneurysm is a ballooning of the main artery in the abdomen. It usually causes no symptoms until it ruptures, which is often fatal. A one-time ultrasound can find a significant aneurysm before that happens.
The strongest recommendation is for men ages 65 to 75 who have ever smoked. For men 65 to 75 who never smoked, clinicians can selectively offer screening based on risk factors such as family history. Men who have already had surgical repair or a prior large aneurysm do not need routine rescreening in the same way.
Medicare and the Annual Wellness Visit
Medicare covers one lifetime AAA screening ultrasound for an eligible person with a referral. Medicare considers you at risk if you have a family history of AAA or are a man ages 65 to 75 who has smoked at least 100 cigarettes; you pay nothing when the provider accepts assignment.
The Medicare Annual Wellness Visit is not the same as a routine physical exam. It is a structured prevention visit, and a separate problem-focused visit may be billed differently. Sources checked July 20, 2026. Independent clinician review is pending.
What this does not mean
A normal one-time AAA ultrasound does not prevent future aneurysms in a different location and does not replace blood pressure control or smoking cessation. It also does not mean you can skip colorectal screening, any ongoing lung CT eligibility, or a PSA discussion if it is still relevant to you.
Screening is a snapshot, not a force field. If you develop new symptoms such as sudden severe abdominal or back pain, seek emergency care.
Questions to bring to a visit
Ask whether your smoking history qualifies you for the AAA ultrasound, whether your plan covers it without cost sharing, and how it fits with your other due screenings.
- Have I ever smoked enough to qualify for AAA screening?
- Is the ultrasound covered under my plan, and where must it be done?
- Which other screenings are still appropriate for me at 65?
Turn reading into a useful next step
Build my men's screening plan
Build my men's screening plan →Frequently asked questions
Is AAA screening painful?
No. It is a painless, noninvasive ultrasound performed on the abdomen, usually finished in minutes.
Do I need AAA screening every year?
No. For eligible men, it is a one-time screening. The follow-up plan depends on the result and your clinician's recommendation.
Does Medicare cover a routine physical?
No. Medicare does not cover a routine physical exam. It covers the Annual Wellness Visit, which is a structured preventive-planning visit, generally once every 12 months.
Sources
- USPSTF: Abdominal Aortic Aneurysm Screening ↗
- Medicare.gov: Abdominal Aortic Aneurysm Screenings ↗
- CMS: Medicare Wellness Visits ↗
- USPSTF: Colorectal Cancer Screening ↗
- USPSTF: Prostate Cancer Screening ↗
- USPSTF: Lung Cancer Screening ↗
Sources checked July 20, 2026. Independent clinician review is pending. Educational only; not a diagnosis, medical advice, coverage determination, or substitute for symptom evaluation.