Does Medicare cover blood work and lab tests?

What lab tests does Medicare cover?

Medicare Part B covers medically necessary diagnostic laboratory tests when your health care provider orders them. Diagnostic lab tests look for changes in your health and help your doctor diagnose or rule out a suspected illness or condition. They may include certain blood tests, urinalysis and certain tests on tissue specimens. Laboratory tests billed by a hospital are among the outpatient hospital services Part B covers.

What do I pay for blood work with Medicare?

You usually pay nothing for Medicare-covered diagnostic laboratory tests. Medicare says you generally pay nothing for these tests when you get them from a laboratory, pharmacy, doctor or hospital that accepts assignment.

Diagnostic tests that aren't lab tests are billed differently. For tests like CT scans, MRIs, EKGs, X-rays and PET scans, you pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026), plus a hospital copayment if you get the test as a hospital outpatient. See what Medicare covers for MRI and CT scans.

Does Medicare cover routine screening blood tests?

Medicare Part B covers certain screenings as preventive services, on set schedules, including the cholesterol and diabetes screening blood tests below. You pay nothing for most preventive services if your provider accepts assignment.

• Cardiovascular disease screening: blood tests for cholesterol, lipid and triglyceride levels, once every 5 years.
• Diabetes screening: up to 2 blood glucose tests a year (fasting or non-fasting glucose, A1C or other Medicare-approved glucose tests) if you have a risk factor like high blood pressure, a history of abnormal cholesterol and triglyceride levels, obesity or a history of high blood sugar, or 2 or more conditions like being 65 or older, being overweight or having a family history of diabetes.
• HIV screening: once a year if you're 15 to 65, or younger or older and at increased risk; up to 3 times during a pregnancy.
• Hepatitis B virus screening: if your provider orders it and you're at high risk or pregnant.

What lab tests might Medicare not pay for?

Medicare covers diagnostic lab tests when they're medically necessary and your provider orders them, and covers screening tests on the schedules Medicare sets. Your doctor may recommend services that Medicare doesn't cover, or more often than Medicare covers them, which could mean extra costs for you. Ask your doctor why a test is recommended and what Medicare will cover. See what Medicare doesn't cover.

Does Medicare Advantage cover lab tests?

Medicare Advantage plans must cover all medically necessary services that Original Medicare covers. Plans can have different out-of-pocket costs, you may need to use providers in the plan's network for non-emergency care, and you may need approval (prior authorization) from the plan before it covers certain services, so check the plan's rules.