Does Medicare Cover Blood Work?

Blood tests are some of the most basic medical tests out there. They can serve many purposes by providing information on your vitamin levels, blood sugar levels, red and white blood cell count, and the presence of disease.

The results of blood tests are some of the most important indicators of our health. The results help our doctors diagnose various health issues and see how our bodies respond to treatment.

Pretty much everyone needs to get blood work – multiple times – in their lives. This brings us to the very common question many have, which is “Does Medicare cover blood work?”

In this article, we answer the question in clear, plain English. You will also find the average costs of blood tests and other helpful information.

Let’s dive into it!

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

First, Original Medicare (Medicare Part A and Part B) provides coverage for blood tests. Generally speaking, Original Medicare provides coverage for your blood tests if they are considered medically necessary.

Which Blood Tests Does Original Medicare Cover?

Under this Medicare plan you will receive coverage for many blood tests as long as it takes place in a Medicare-approved facility. Original Medicare provides coverage for many types of blood tests, including the following:

Complete blood count
Blood chemistry tests
Blood enzyme tests
Thyroid blood tests
Lipoprotein panel
Fecal occult blood test

When Does Medicare Part A Provide Coverage?

Blood tests are covered by Medicare Part A if they take place in an inpatient setting. Medicare Part A will cover 100 percent of the costs of hospital stays for up to 60 days.

Starting from the 61st day up to 90 days, Medicare Part A will still provide coverage. However, you will have a daily copayment you will be responsible for. After 90 days, Medicare Part A will no longer provide coverage.

But Medicare Part A does provide 60 lifetime reserve days. If you still have these available, then Medicare will still provide coverage for your hospital stay after 90 days, but you will have a daily copayment.

When Does Medicare Part B Provide Coverage?

On the other hand, Medicare Part B provides coverage for blood tests that take place in an outpatient setting. In fact, a blood test is usually done on an outpatient basis.

Medicare Part B covers 100 percent of the costs of many blood tests. Once approved, Medicare Part B covers 80 percent of the costs of specific blood tests. You will pay for the remaining 20 percent.

Does Medicare Advantage Cover Blood Tests?

If you have a Medicare Advantage plan (Medicare Part C), your plan will also provide coverage for blood tests. These plans must offer all the same benefits and coverage as Original Medicare covers.

Part C plans will also provide coverage for health-related services, tests, treatments, etc., that Original Medicare does not cover. Exactly what additional coverage a plan offers and the out-of-pocket costs will depend on your plan.

How Much Do Blood Tests Cost?

If you don’t have insurance coverage, it’s hard to calculate an average cost for blood tests. That’s because there is such a wide range of costs. Some blood tests only cost a few dollars, while others cost over $1,000.

How much a test costs depends on the type of blood test you get. The facility or lab where you get the testing done also plays a big role in how much a test costs.

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