What Blood Tests Does Medicare Cover?

Christian Worstell
In this article...
  • Medicare covers blood tests for diabetes, heart disease, hepatitis, various types of cancer and more. Learn what blood tests Medicare pays for, and find out how much you can expect to pay.

When does Medicare cover blood work? When they’re ordered by a doctor to monitor or test for certain conditions, such as diabetes, sexually transmitted diseases, hepatitis, heart disease and other conditions.

A blood test is covered by Medicare if your doctor decides it is medically necessary.

Privately sold Medicare Advantage (Medicare Part C) plans cover the same blood work and other lab tests that federally administered Original Medicare (Part A and Part B) covers, and some plans may cover more benefits than Original Medicare covers.

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What Tests Does Medicare Cover?

Some of the blood tests covered by Medicare include tests for:

  1. Diabetes – Medicare covers a blood test for diabetes once per year, or up to twice per year for high-risk individuals who have risk factors such as a history of high blood pressure or hypertension, a history of abnormal cholesterol or triglyceride levels, a history of high blood sugar or obesity.

  2. Heart disease – A  blood test is covered by Medicare once every five years to check your cholesterol, lipid (blood fat) and triglyceride levels to determine if you’re at risk for a heart attack or stroke.

  3. HIV – Medicare covers blood tests for HIV screening once a year based on risk. Pregnant women can get an HIV blood test covered by Medicare up to 3 times during their pregnancy.

  4. Hepatitis B & C – An HBV infection screening is covered by Medicare if you’re at elevated risk for Hepatitis B or if you’re pregnant. The blood test is covered once a year if you’re at high risk, and it’s covered at various points of your pregnancy depending on your risk level. Medicare covers Hepatitis C blood tests once a year if you’re at high risk or meet certain other factors.

  5. Colorectal cancer – Medicare covers a fecal occult blood test screening once a year if you’re 50 or older and have a referral form your doctor or other health care professional.

  6. Prostate cancer – Once a year, Medicare covers prostate specific antigen (PSA) blood tests for men over 50.

  7. Various sexually transmitted diseases – Medicare covers blood tests for sexually transmitted infections (STI) once a year. The tests screen for chlamydia, syphilis, Hepatitis B and/or gonorrhea.

  8. Coronavirus disease 19 (COVID-19) antibody test
    Also called a serology test, coronavirus tests are covered to see if your immune system responded to COVID-19 exposure and infection.

Medicare Part B covers clinical diagnostic lab tests such as blood tests, tissue specimen tests, screening tests and urinalysis when your doctor says they’re medically necessary to diagnose or treat a health condition.

How Much Do Blood Tests Cost With Medicare?

Medicare Part B provides coverage for medically necessary clinical diagnostic laboratory services when ordered by a doctor according to the timelines above. Beneficiaries typically do not pay anything for these blood tests as long as they are performed by a Medicare-approved health care provider. 

However, if more frequent blood tests are needed due to your risk factors or health condition, you may be required to pay 20% of the blood test cost of the Medicare-approved amount after you meet your annual Part B deductible. 

A Medicare Supplement (also called Medigap) plan is a type of insurance plan you can buy that will help pay for certain Original Medicare copays, coinsurance, deductibles and other costs.

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

Does Medicare Cover Other Annual Tests?

Medicare lab coverage includes a number of other services in addition to blood tests. Depending on qualifying criteria, you may pay nothing for these tests.  

Some of the additional tests covered by Medicare include:

  • Mammograms for breast cancer
  • Pap smears for cervical cancer
  • Bone density tests for osteoporosis 
  • Stool tests, enemas, colonoscopies and flexible sigmoidoscopies for colon cancer
  • Abdominal ultrasounds for aortic aneurysms 
  • Low dose computed tomography (LDCT) for lung cancer
  • Eye tests for glaucoma

Medicare also covers screenings for alcohol and substance abuse and obesity.

Once a year, beneficiaries are covered for an annual wellness visit. The visit does not include any blood tests but does feature other tests and screenings for various health issues. 

The official Medicare website provides this detailed list of the types of tests, items and services that are covered.

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.