Does Medicare Cover Thyroid Tests?
- Living with thyroid problems can be uncomfortable. Find out if Medicare will cover the cost of thyroid tests to detect hypothyroidism or hyperthyroidism.
If your doctor suspects that your thyroid is malfunctioning — either by producing too much thyroid hormone or too little — they'll likely send you for thyroid testing. Find out whether Medicare covers thyroid tests and if you should expect to spend any of your own money on testing.
Does Medicare Cover Thyroid Tests?
When thyroid testing is requested by a medical doctor, Medicare Part B normally covers the cost of your test. However, there are a couple of requirements that need to be met for your test to be covered.
- You need to visit a laboratory that's Medicare-approved.
- You must exhibit symptoms of a thyroid function problem.
If you're a member of a Medicare Advantage Plan, or Medicare Part C, you should have the same coverage for thyroid testing. However, depending on your plan, you may be required to visit an in-network laboratory if you're covered by Medicare Advantage.
Is a Thyroid Function Test Covered by Medicare?
The most common thyroid tests ordered by doctors are thyroid stimulating hormone (TSH) and free thyroxine (FT4) tests. These tests are covered by Medicare as long as you meet the requirements mentioned above. Any other thyroid test is generally only covered by Medicare if there's already a history of thyroid problems.
How Much Is Covered?
Normally, the entire cost of a thyroid test and any other necessary blood work will be covered under your Medicare plan. However, you'll have to have met your deductible for the year. As of 2021, the Medicare Part B deductible was $203 annually.
What Is a Deductible?
Your deductible is the amount you're required to pay for your own health care expenses before Medicare will cover your costs. That means if your test costs $300 and you haven't paid for any health care costs yourself so far this year, you'll need to pay $203 (or the current deductible amount) before Medicare will cover the remainder of your thyroid test cost.
If your thyroid symptoms aren't severe, Medicare will typically cover up to two tests each year. This lets your doctor effectively screen you for thyroid malfunction if you're exhibiting suspicious symptoms.
In some cases, Medicare may approve additional tests during the year. This exception typically applies to those with thyroid cancer, severe symptoms or testing new thyroid medications. Additionally, if you have a diagnosis of acquired hypothyroidism or thyroiditis, TSH testing is typically covered without the two-test limitation.
What Do Thyroid Tests Determine?
There are several health conditions that can occur as a result of thyroid malfunction. That includes hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), Graves' disease, Hashimoto's disease and thyroid growths. The symptoms of these conditions vary but typically include problems regulating your body temperature, sleep-related issues and mental health concerns.
Several blood tests exist to detect these conditions. While TSH, FT3 and FT4 tests can diagnose hypothyroidism and hyperthyroidism, thyroid antibody tests may be conducted to diagnose Graves' or Hashimoto's disease. If you have nodules (small growths) or a goiter on your thyroid, these tests can also help your doctor to detect the effect they may be having on your body.