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does Medicare cover thyroid blood test

Does Medicare Cover a Thyroid Blood Test?

The thyroid is a gland that regulates many bodily functions. There are a few conditions that affect the thyroid that can cause health issues.

A common one is hyperthyroidism. This is when your thyroid is overactive and releases too many hormones. On the other hand, hypothyroidism is the exact opposite.

If you think you are having some problems with your thyroid, it is best to undergo a test.

So a common question many people have is, “does Medicare cover a thyroid blood test?” In this article, we answer that question in clear, plain English. You will also find the average costs of thyroid blood tests and other helpful info.

Does Medicare Cover a Thyroid Blood Test?

The short answer is yes; Medicare will cover the cost of thyroid blood tests. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your thyroid blood tests. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for thyroid blood tests. Coverage for thyroid blood tests is provided by Medicare Part B. However, for Medicare Part B to provide coverage for your thyroid blood tests, you must meet the following conditions:

  • You are experiencing symptoms that could be linked to your thyroid function
  • Your healthcare provider will have to certify that the thyroid blood test is medically necessary
  • The thyroid blood test will take place in a Medicare-approved facility/laboratory

Here are some reasons why a thyroid blood test may be medically necessary: 

  • Your thyroid has a goiter or a nodule
  • You are experiencing symptoms of hypothyroidism which may include the following:
    • Fatigue or lacking energy
    • Sensitivity to cold
    • Constipation;
  • Or you are experiencing symptoms of hyperthyroidism which may include the following:
    • Mood swings
    • Problems sleeping
    • Muscles feel weak
    • Diarrhea
  • You started taking thyroid medications and your healthcare provider needs to monitor your progress

Most of the time, Medicare Part B provides coverage for two thyroid tests per year for those who are clinically stable. However, you may get additional coverage if you have prior authorization from Medicare.

Medicare Part B will provide coverage for frequent thyroid blood tests if you:

  • Have had thyroid cancer
  • Started taking thyroid medications
  • Started experiencing symptoms related to your thyroid

Most of the time, Medicare Part B provides coverage for 100 percent of the costs of medically necessary laboratory tests, including a thyroid blood test. 

Part C Coverage for Thyroid Blood Tests

Medicare Advantage plans (Medicare Part C) also provide coverage for thyroid blood tests. They cover everything Original Medicare covers plus some additional benefits. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.

How Much Does A Thyroid Blood Test Cost?

A thyroid blood test may cost somewhere from $30 to $500, depending on what type of test you will be having. One of the cheaper tests is the T3 test, which ranges from around $35 to $100. Radioactive iodine uptake tests are some of the most expensive tests, costing from around $300 to $500.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover pneumonia shots?

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