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A pap smear is a test that can help detect cervical or vaginal cancer in the early stages. It can detect both cancer and precancer in the cervix. By detecting it early, there is a higher chance of successful treatment.
A pap smear test can detect other issues as well. These include sexually transmitted diseases (STDs), fibroids, and other vaginal issues.
So a common question many people have is, “does Medicare cover pap smears?” In this article, we answer that question in clear, plain English. You will also find the average costs of pap smear tests, as well as other helpful info.
Does Medicare Cover Pap Smears?
The short answer is yes; Medicare will cover the cost of pap smear tests. 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 pap smear test. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for pap smear tests. Coverage for a pap smear test will usually fall under Medicare Part B.
Part B provides coverage for a pap smear test, a pelvic exam, and a breast exam once every 24 months for all female Medicare-enrollees. These tests are considered preventive care and services.
However, Medicare Part B may provide coverage for these tests once every 12 months if you are at high risk of having cervical or vaginal cancer. And also if you are of childbearing age and have had an abnormal pap smear in the past 3 years.
Medicare considers that you are at high risk of developing cervical or vaginal cancer if you:
- Were sexually active before the age of 16
- Have had sexual intercourse with 5 or more different people
- Have had an STD
- Your mother took diethylstilbestrol (DES) during her pregnancy
- Had three or fewer negative pap smears within the last 7 years.
If you qualify, Medicare Part B will cover 100 percent of the Medicare-approved amount. That is assuming you get the test from a Medicare-approved provider.
There’s one more thing to understand here. Let’s say that, during a pap smear, your doctor discovers a new or existing medical issue. In this case, the care that you get will be considered as diagnostic care and Medicare Part B may bill you for it.
Part C Coverage For a Pap Smear Test
Medicare Advantage plans (Medicare Part C) also provide coverage for a pap smear test as well as a pelvic exam and a breast exam. They cover everything Original Medicare covers, as well as offer some additional benefits. However, exactly what they cover and how much the out-of-pocket costs are will vary depending on the specifics of your plan.
How Much Does A Pap Smear Test Cost?
Most of the time, a conventional pap smear test may cost between $25 and $40. However, a liquid-based pap smear test, also known as ThinPrep, may cost a bit more. They typically range from $45 to $60.
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 Tdap immunization?