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Does Medicare Cover Blood Tests?

Medicare Part B covers some laboratory tests that are considered medically necessary, including blood tests. There are a variety of tests that screen for certain conditions that Medicare will cover at specific intervals. Learn more about Medicare’s coverage for blood tests below.

What Blood Tests Are Covered by Medicare?

Below, we list several types of lab work Medicare does cover if considered medically necessary. If you think you need blood work done, we recommend speaking with your health care provider to find out whether or not Medicare does cover blood tests for what you need.

Diabetes Tests

Screening for diabetes is an important step in diagnosing the disease. Medicare Part B may cover two diabetes screenings per year if you get a referral from a doctor or have any of the following risk factors:

  • High blood pressure
  • Obesity
  • History of high blood sugar
  • History of abnormal cholesterol levels

Also, Medicare Part B will generally cover two diabetes screenings a year if two or more of the following applies to you:

  • You are 65 years or older
  • You have a family history of diabetes
  • You have a family history of gestational diabetes
  • You are overweight

Prostate Cancer Tests

Prostate Specific Antigen (PSA) tests screen for prostate cancer in men. Generally, Medicare will cover one PSA test every 12 months if recommended by a doctor. 

Does Medicare Cover Blood Tests for Cholesterol?

Maintaining healthy cholesterol levels can help reduce your risk of heart disease and heart attacks. If ordered by a doctor, Medicare will cover screenings for cholesterol, lipid and triglyceride levels every five years.

Hepatitis C Tests

Your hepatitis C test will generally be covered by Medicare if:

  • You’re at high risk because of a history of injection-drug use
  • You’re at a high risk because you had a blood transfusion before 1992
  • You were born between 1945 and 1965

Medicare covers a one-time test to screen for Hepatitis C, as well as annual tests for those who are at a higher risk. However, the test must be ordered by a primary care doctor or practitioner to be covered.

STI Tests

Medicare covers blood tests to detect sexually transmitted infections (STIs), including:

  • Gonorrhea
  • Syphilis
  • Chlamydia
  • Hepatitis B

Typically, tests for these STIs are covered by Medicare every 12 months or at certain times during a woman’s pregnancy.

Out-of-Pocket Costs

Your provider may recommend that you get more tests than those which Medicare will cover. In these cases, you may be responsible to pay out of pocket for the test.

Though many of these blood tests are completely covered by Medicare, you may have to pay out-of-pocket costs in the form of deductibles, copayments, coinsurance and other expenses for other medical services.

 

Medicare Supplement Insurance can help cover your out-of-pocket blood test costs.

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