Are Lab Tests Covered by Medicare?

Find Out if Your Lab Test Is Covered by Medicare

Most Medicare recipients will need to have lab work for one reason or another in the coming years. Depending on the situation, if you have Medicare Part A and/or Part B, your lab test is likely covered. However, there are some tests that might need to be paid out of pocket or covered by other insurance, and you might need to pay a deductible.

Lab Tests Not Covered by Medicare

Some of the lab tests not covered by Medicare are those related to obscure medical conditions and diseases. Most experimental lab tests are not covered by Medicare, but the list changes periodically as more is learned. If a test is considered not reasonable and/or necessary, coverage will be declined by Medicare.

Out of Pocket Lab Tests for Seniors

Some out of pocket lab tests for seniors is determined by the lab where the test is done. Many labs and pharmacies offer COVID testing, including home tests, free of charge regardless of insurance. Others require Medicare or other insurance to cover the tests. COVID is one example of the constant influx of new information about the disease, which in turn affects availability and cost of testing.

The cost of most lab tests is affected in large part to knowledge of particular diseases and condition for which your doctor prescribes the test. You can usually expect to have an out-of-pocket expense for lab tests that are uncommon combined with your particular Medicare coverage.

Medicare-Approved Lab Tests

One of the most routinely Medicare-approved lab tests is a blood test. Having your blood tested on a regular basis to check levels for problems related to cholesterol, kidney and liver function, anemia, clotting, and heart disease are some of the basic tests that are almost always approved by Medicare. Diabetes is common in older patients, and a blood test is one way to monitor this disease, so it will likely be approved.

Many common diagnostic tests such as thyroid, diabetes, urinalysis and others that your physician requests and that are on the current Medicare-approved list will be covered. Changes in covered lab work can occur from year to year, so check with your insurance provider before making the trip to the lab.

Medically Necessary Lab Tests

If your doctor requests a medically necessary lab test on an outpatient basis, Medicare probably covers this test or tests. Inpatients with Medicare Part A who require standard lab tests or specific diagnostic lab tests will probably be covered by Medicare.

For a complete up to date list of Medicare-approved lab tests, your insurance provider or one of our team members at Medicare Insurance Advisors can help.

Contact Medicare Insurance Advisors today for guidance in navigating your Medicare coverages. We are here to answer questions you might have regarding your Medicare policy.