Key takeaways
- Original Medicare (parts A and B) covers most medically necessary blood tests.
- Usually, you do not need to pay for a diagnostic blood test. However, the plan deductible and 20% coinsurance may apply.
- Medicare Advantage (Part C) plans also cover blood tests, and coinsurance and copayments may apply. You may also need to use specific in-network laboratories.
Medicare covers most types of blood tests that allow a healthcare professional to track your health and even screen for disease prevention. Coverage depends on meeting Medicare’s eligibility criteria.
Medicare Advantage (Part C) plans may cover more tests than Original Medicare (parts A and B) plans. Under Original Medicare, there is no separate fee for blood tests.
Medicare supplement (Medigap) plans may help with out-of-pocket costs like deductibles, coinsurance, or copayments.
Medicare covers most blood tests that are medically essential.
In some instances, you may be required to pay for some or all of a blood test, but the reasons for this and the individual costs will vary.
Always check with Medicare or your Part C plan provider about whether a blood test is covered.
Medicare Part A covers medically necessary blood tests when you are considered an inpatient. This could be at a hospital, skilled nursing facility, hospice, or other eligible facility.
Medicare Part B covers outpatient blood tests a physician orders to diagnose or manage a health condition.
Medicare Advantage, or Part C, plans also cover blood tests. These plans may also cover additional tests not covered by Original Medicare (parts A and B). Some Medicare Advantage plans have network restrictions, meaning that you may have to visit a specified, in-network lab for a blood test, but this can vary by plan.
Each Medicare Advantage plan offers different benefits, so check with your plan about specific blood tests.
Medicare costs for blood tests can vary and are typically based on the specific test, your location, and the lab you use.
Medicare Part A costs
In-hospital blood work a doctor orders is generally fully covered under Medicare Part A. However, you still need to meet your deductible.
In 2025, the Part A deductible is $1,676 per benefit period, which begins the day you enter the hospital and ends when you haven’t received any inpatient care for 60 consecutive days. Multiple benefit periods can occur in a year.
Medicare Part B costs
Medicare Part B also covers medically necessary outpatient blood tests. You must first pay your annual deductible, which is $257 for most people in 2025.
Remember, you must also pay your monthly Part B premium, which will be $185 in 2025 for most beneficiaries.
Medicare Advantage costs
Costs with a Medicare Advantage plan depend on the individual plan’s coverage. You can check Medicare’s plan finder for Medicare Advantage plans in your area, and check any copayments, deductibles, and any other out-of-pocket costs.
Some Medicare Advantage plans offer expanded coverage options, so you may have very few out-of-pocket costs.
Medigap costs
Medigap (Medicare supplement insurance) plans can help pay for some of the out-of-pocket costs associated with Original Medicare only, including coinsurance, deductibles, and copayments.
Each of the 10 standard Medigap plans available have different benefits and costs, so careful research is important to find the best value for your needs. Two of the plans also have high deductible versions available.
TipThere are some situations when blood test costs may be higher than usual, including when:
- You visit labs that don’t accept assignment.
- You have a Medicare Advantage plan and choose an out-of-network doctor or lab facility.
- Your healthcare professional orders a blood test more often than is covered, or if Medicare does not cover the test.
The Medicare website has a search tool to find participating doctors and labs.
You can have blood tests at several types of labs. A doctor or another healthcare professional will let you know where you can get the tests done. Just make sure the facility or provider accepts Medicare.
Types of labs covered by Medicare include:
- doctor’s offices
- hospital labs
- independent labs
- nursing facility labs
- other institution labs
If you receive or are asked to sign an Advance Beneficiary Notice (ABN) from the lab or service provider, you may be responsible for the cost of the service because it is not covered. It’s best to ask questions about your responsibility for costs before you sign this document.
Original Medicare and Medicare Advantage plans cover many types of screening and diagnostic blood tests. However, Medicare may limit the frequency with which it covers certain tests.
You can appeal a coverage decision if you or your doctor believes a test should be covered. Certain screening blood tests, like those for heart disease, are fully covered with no coinsurance or deductibles.
Here are some of the conditions that are commonly screened through blood tests and how often you can have them with Medicare coverage:
- Diabetes: once a year or up to twice per year if you are at higher risk
- Heart disease: cholesterol, lipids, and triglyceride screenings once every 5 years
- HIV: once a year based on risk
- Hepatitis (B and C): once each year, depending on your risk
- Colorectal cancer: once each year
- Prostate-specific antigen (PSA): once each year
- Sexually transmitted infections (STIs): once each year
If a doctor or healthcare professional thinks you need more frequent testing due to your specific risk factors, you should consider discussing this with Medicare to avoid unexpected costs.
Medicare Part B covers many outpatient doctor-ordered tests, such as urinalysis, tissue specimen tests, and screening tests. There are no copays for these tests, but your deductible still applies.
Examples of covered tests and screenings include:
| Condition | Screening | How often |
|---|---|---|
| breast cancer | mammogram | once per year* |
| cervical cancer | pap smear | every 24 months |
| osteoporosis | bone density or bone mass measurements | every 24 months |
| colon cancer | multitarget stool DNA tests | every 36 months |
| colon cancer | blood-based biomarker tests | every 48 months |
| colon cancer | flexible sigmoidoscopies | every 48 months |
| colon cancer | colonoscopy | every 24 to 120 months based on risk |
| colorectal cancer | fecal occult blood test | once every 12 months |
| abdominal aortic aneurysm | abdominal aortic ultrasound | once per lifetime |
| lung cancer | low dose computed tomography (LDCT) | once per year, if you meet specific criteria |
*Medicare covers diagnostic mammograms more often if your doctor orders them, and you will typically pay a 20% coinsurance.
Other nonlaboratory diagnostic screenings Medicare covers include:
- X-ray
- PET scan
- MRI
- EKG
- CT scan
Copayments, coinsurance, and deductibles may apply to these tests.
Remember to visit providers that accept Medicare to avoid unexpected costs.
Helpful links and tools
- Medicare has a tool that you can use to check which tests are covered.
- You can also review the list of tests it covers.
- You can look through items Medicare does not cover. Before signing an ABN, ask about the cost of the test and shop around. Prices vary by provider and location.
Medicare covers many types of medically necessary, common blood tests needed to diagnose and manage health conditions.
Ask your doctor or healthcare professional for information on your particular type of blood test and how to prepare.
If you have a condition that requires more frequent testing, you can consider a Medicare supplement insurance plan like Medigap to help with out-of-pocket costs.