Your Health Screening Roadmap: What to Get Checked, When, and What It Costs
A decade-by-decade breakdown of the preventive tests worth putting on your calendar — and how a body composition scan fits alongside them.
Most of us know we're "supposed to" get checkups, but the actual list of what to test, how often, and what it should run you rarely gets spelled out in one place. Screening guidelines shift over time, insurance rules are confusing, and it's easy to let a test lapse simply because nobody sent a reminder. This guide lays out the core preventive screenings recommended for adults, organized by decade, along with realistic cost expectations and where a DEXA body composition scan can add useful context along the way.
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Why Preventive Screening Pays Off
The whole point of screening is catching problems while they're still quiet — high blood pressure, rising blood sugar, thinning bone, a slow drift in body composition — before they turn into something symptomatic. The tricky part is that "silent" conditions don't create urgency on their own, which is exactly why so many people fall behind on tests that would otherwise be routine and inexpensive.
Under the Affordable Care Act, screenings that carry an A or B recommendation from the U.S. Preventive Services Task Force are generally covered at no out-of-pocket cost when you use an in-network provider. That covers a surprising amount of ground: blood pressure checks, cholesterol and glucose panels, several cancer screenings, and more. The catch is that coverage only helps if you actually book the appointment.
The Decade-by-Decade Checklist
Recommendations vary somewhat by sex and personal risk factors, so treat the list below as a starting point for a conversation with your primary care provider, not a substitute for one.
In Your 20s
- Blood pressure check — every 3–5 years if consistently under 120/80, more often otherwise.
- BMI and waist circumference — annually.
- STI/HIV screening — at least once, yearly if you have risk factors.
- Pap test (for people with a cervix) — every 3 years starting at 21.
- Monthly skin self-checks for new or changing moles.
In Your 30s
- Lipid panel and fasting glucose — every 4–6 years, sooner with risk factors.
- Pap plus HPV co-testing — every 5 years.
- A mental health check-in as part of your annual physical.
- Continued monthly skin checks.
In Your 40s
- A1c or fasting glucose — every 3 years if BMI is 25+ (23+ for Asian Americans).
- Mammograms — every 1–2 years starting at 40.
- Colorectal cancer screening — begin at 45 (annual FIT test, stool DNA test every 3 years, or colonoscopy every 10 years).
- Continued skin self-checks.
Ages 50–64
- Continue colorectal screening on the interval set by your prior results.
- Bone density (DEXA) scan for postmenopausal women with risk factors.
- PSA discussion for men — starting around 50, frequency based on baseline result.
- Shingles and pneumococcal vaccines as recommended.
- Annual mental health check-in.
Age 65 and Up
- One-time abdominal aortic aneurysm ultrasound for men 65–75 who have ever smoked.
- Annual hearing and vision checks.
- Annual fall-risk / balance assessment.
- Bone density DEXA every 2–5 years (women) or starting around 70 (men, earlier if high risk).
- Annual cognitive and mood screening.
Diagnostic DEXA vs. Body Composition DEXA
These two scans use the same underlying technology but serve different purposes, and it's worth knowing which one you're getting.
| Type | Purpose | Who orders it | Typical cost |
|---|---|---|---|
| Diagnostic bone-density DEXA | Diagnoses osteoporosis via T-score | Physician referral, done at a radiology center | Often covered by insurance for women 65+, men 70+, or earlier with risk factors |
| DexaScan body composition scan | Measures fat, lean mass, and bone data for tracking — not diagnostic | Self-scheduled, no referral needed | Self-pay, typically FSA/HSA eligible |
What These Tests Typically Cost
Cash prices vary by region and provider, but here's a general sense of what to expect if you're paying out of pocket or your plan doesn't cover a given test.
| Screening | Typical range | Coverage note |
|---|---|---|
| Blood pressure check | Free | Included in almost any office visit |
| Lipid panel | $35–$70 | Often free in-network every 4–6 years |
| A1c | $28–$80 | Frequently covered when BMI criteria are met |
| DexaScan body composition scan | Starting at $99 | FSA/HSA eligible |
| Bone density DEXA (diagnostic) | $85–$200 | Medicare-covered every 2 years if eligible |
| FIT stool test | $25–$40 | Usually covered annually starting at 45 |
| Colonoscopy | $1,400–$3,000 | Covered every 10 years as a screening exam |
| Mammogram | $100–$300 | Typically fully covered for insured patients 40–74 |
| PSA test | $35–$70 | Coverage varies by plan |
| Pap + HPV co-test | $25–$150 | Covered on the guideline-recommended interval |
Prices are general national estimates and will vary by location and facility. Always confirm coverage with your insurer before scheduling.
Common Questions
Which screenings matter most if I can only prioritize a few?
Blood pressure and lipid/glucose checks catch the most common silent risk factors, and the cancer screenings tied to your age and sex (mammogram, colorectal, cervical, prostate) carry the strongest evidence behind them. Body composition tracking is a useful add-on for anyone focused on weight management, athletic performance, or healthy aging.
Are these screenings really free?
If a test has a USPSTF A or B rating and you see an in-network provider, the ACA requires it to be covered with no copay. Costs can still show up if a screening turns diagnostic mid-procedure (like a polyp removal during a colonoscopy) or if you go out-of-network.
How often should I get a DEXA scan?
A diagnostic bone-density scan generally runs every 2 years when indicated. A body composition scan is typically most useful scanned monthly to quarterly, since the value comes from tracking trends over time rather than a single snapshot.
I feel completely healthy — do I still need to bother?
That's exactly the population these screenings are designed for. Conditions like hypertension, prediabetes, and low bone density typically produce no symptoms until they've progressed, which is why catching them early makes such a difference.
Can I combine several screenings in one trip?
Often, yes. A body composition scan usually takes well under 15 minutes, so it's easy to pair with a same-day physical or a fasting lab draw if you plan the visit around your lab requirements.
Putting It Into Action
- List out which screenings you're due for this year based on your age and sex.
- Set calendar reminders now, rather than waiting for a symptom to prompt you.
- Compare cash prices where relevant, and use FSA/HSA funds where eligible.
- Track results over time rather than treating each test as a one-off.
- Revisit this list annually — guidelines and your own risk factors both shift.
Ready to add body composition tracking to your routine?
Book a DexaScan appointment near you and get precise fat, muscle, and bone density data in about 10 minutes.
Find a DEXA Scan Center Near YouThis article is for general educational purposes and is not a substitute for individualized medical advice. Talk with your healthcare provider about which screenings are right for you.