Does Medicare Cover Lyme Disease Testing?

Lyme disease is contracted through infected black-legged tick bites and can result in many health complications. This disease can be a very challenging disease to live with, but it can be well-managed if detected and treated early.

So, it is important to get tested right away if you suspect you have it. But, “Does Medicare cover Lyme disease testing?”

In this article, we answer the question in clear, plain English. You will also find the average Lyme disease testing costs and other helpful information.

Does Medicare Cover Lyme Disease Testing?

The short answer is no. In most cases, Medicare will not cover the cost of Lyme disease testing. However, there may be some situations where you can get these costs covered.

Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Lyme disease testing.

Original Medicare Coverage of Lyme Disease Testing

Original Medicare (Medicare Part A and Part B) likely does not provide coverage for Lyme disease testing. As of now, there is no sufficient data on whether Original Medicare provides coverage for Lyme disease or not.

This means you will likely have to pay 100 percent for your Lyme disease testing.

When might Medicare cover testing?

Potential Coverage of Lyme Disease Testing

Most healthcare insurance companies do not provide coverage for long-term Lyme disease treatment as it is not considered a legitimate disease. The CDC also states that Lyme disease can be treated with antibiotics within 30 days.

While insurance plans like Medicare typically do not cover at-home testing, they may provide coverage for Lyme disease testing if a healthcare provider orders it.

If you can’t get insurance coverage, you can check out The Lyme Test Access Program (Lyme-TAP). This grant is offered through the Rotary Club of Southwest Eureka Foundation and provides 75 percent reimbursement for your Lyme disease testing costs.

This testing just has to be done in a CLIA/Medicare-approved laboratory. This is a nationwide program.

Medicare Advantage Coverage of Lyme Disease Testing

Similar to Original Medicare, Medicare Advantage plans (Medicare Part C) do not cover Lyme disease testing.

Medicare Advantage plans cover everything Original Medicare covers but offer additional benefits as well. But, based on our research, Lyme disease testing does not seem to be an added benefit commonly offered.

How Much Does A Lyme Disease Test Cost?

Lyme disease tests usually cost somewhere from $50 to $600. This depends on whether you choose to take an at-home test or go to a laboratory.

Most home test kits cost around $100.

There are a few different types of tests for Lyme disease. Blood tests are the best way to identify if you have Lyme disease or not, according to the CDC.

What Do Lyme Disease Testing Kits Typically Include?

What is inside a Lyme disease testing kit generally varies from test kit to test kit. However, most of the time, it includes the following items:

The device needed to collect the blood, urine, or saliva sample
Instructions
The container to ship the sample back to the lab
A shipping label

Certain kits may include additional items such as bandages or wipes.

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.