Does Medicaid Cover Blood Tests?
- Does Medicaid cover blood tests? Medicaid coverage for certain diagnostic tests can be complex. Find out what tests Medicaid covers and when benefits apply.
Your doctor can order blood work for a number of reasons. Blood tests are often included in regular exams, such as an annual physical. They can also be ordered as standalone tests at regular intervals to help your doctor keep up on the state of your health. People who participate in the Medicaid program for low-income health coverage can usually get needed blood work done under their policies, but certain restrictions may apply.
Does Medicaid Cover Blood Tests?
Medicaid pays for blood tests when they are ordered by a doctor as part of needed medical treatment. Laboratory tests are included as a mandatory benefit in all 51 Medicaid programs in the United States as a covered benefit. These tests are often done as part of other covered Medicaid services, such as hospitalization and outpatient medical exams. If you get care from an HMO, it is likely you get blood work within the network. If your provider is authorized to bill Medicaid, payments are processed in the same way as your other medical care.
Medicaid at the State Level
Medicaid is organized as a joint federal-state program, with some funding provided by the federal government and administration done at the state level. For many services, states have a wide latitude over which services they cover and which they don't. Some medical services, however, are required by the federal rules for Medicaid. Blood tests ordered by a doctor are required services in all 50 states and the District of Columbia.
Getting a Blood Test From Your Provider
Blood tests generally don't require preapproval from Medicaid before they are ordered. Covered tests can be done at any authorized site, such as the doctor's office, inside the hospital or at an affiliated clinic. As long as the provider is an authorized Medicaid biller in your state, the tests ordered by your doctor can be paid by your plan.
At-Home Blood Tests
Some blood tests can be done at home. Apart from routine blood sugar testing, which Medicaid includes as part of its required coverage for diabetes testing and supplies, at-home blood tests can also be a covered benefit under Medicaid, provided they are deemed medically necessary. Supplies for testing are part of your Medicaid coverage and can usually be provided at the doctor's office, at the pharmacy or delivered to your address.
Does Quest Accept Medicaid?
Quest Diagnostics is a private laboratory that offers blood work to many medical providers. In the states where Quest operates, it is able to offer blood tests ordered by a doctor under the usual Medicaid coverage umbrella. Coverage for Quest services is not universal, however. In several states, Quest provides covered diagnostic services as part of a limited package that has been approved by Medicaid. In California, for example, Medicaid does pay for Quest services that fall within an approved package, such as prenatal services, H. pylori testing and hCG prolactin screening for certain types of cancer.
How Much Does Quest Blood Work Cost?
For those without Medicaid coverage or whose Medicaid plan will not pay for a specific series of blood tests, it may be necessary to pay for blood work out of pocket. Quest Diagnostics' prices for these tests vary somewhat between locations, but all are within similar ranges. Simple tests at a Quest lab cost as little as $100 while more sophisticated and extensive testing may cost a few thousand dollars. In 2021, a simple hemoglobin blood count, for example, costs $8 at Quest Diagnostics while a full obstetric panel on its own can cost $488.