Does Medicare Cover Pap Smears?

In this article...
  • Medicare can be used for a wide array of services. Pap smears are an important component of preventative health. Find out if Medicare covers Pap smears.

Medicare provides insurance for those over the age of 65 as well as some individuals younger than that with disabilities or certain chronic/terminal health conditions. For women, preventative care services that include annual Pap smears is an important consideration. 

Determining what Medicare does and does not cover in terms of women's health as it relates to Pap smears is key to a comprehensive approach to care. 

What Is a Pap Smear?

A Pap smear is a preventative procedure that collects cells from a woman's cervix to test for cervical cancer. 

Early detection of cervical cancer increases chances of remission/survival. A Pap smear can also indicate the potential for future issues when changes in the cell lining of the cervix are noted. 

A Pap smear is generally part of a larger pelvic exam. For women age 30 and older, the examination is generally conducted in conjunction with testing for human papillomavirus (HPV), which can contribute to the development of cervical cancer. 

For women age 65 and older, Pap smears no longer have to be conducted annually if previous Pap smears have been within normal parameters. 

Does Medicare Cover Pap Smears?

Medicare Part B, which is the component that covers preventative health care, covers Pap smears and pelvic exams. Beneficiaries may receive these screening tests once every 24 months under Part B coverage with the exception of those considered high-risk. 

Women in the high-risk category include those of child-bearing age, women who have had an abnormal Pap smear in the last 36 months and individuals with other risk factors that predispose them to cervical or vaginal cancer. In these cases, Medicare covers Pap smear screenings every 12 months. 

What Other Components of Women's Health is Covered by Medicare

Medicare also covers an HPV test every 5 years for those between the age of 30 and 65, whether symptoms are present or not. Breast exams are also covered by Part B. 

Costs

For those who qualify, Part B covers Pap smears, breast and pelvic exams at full cost when using a Medicare-approved provider. This means there is no deductible, copay or coinsurance cost; Medicare pays for 100% of the service. 

Medicare Advantage plans also cover the cost of these screenings at 100% for those providers working in-network, even though these insurers are private. 

To find out more about the extent to which Medicare covers Pap smears, women's health or other related services, visit https://www.medicare.gov/coverage/cervical-vaginal-cancer-screenings