Medicare has two parts: Part A and Part B. In general, Part A covers inpatient hospital care, skilled nursing facility care, nursing home care that is not custodial or long-term, hospice care, and home health care. Part B covers medically necessary services to diagnose or treat medical conditions; and preventive services. Part B can cover clinical research, ambulance services, durable medical equipment, mental health, limited outpatient prescription drugs. Part B covers health tests and screenings, including lab tests, X-rays, and bloodwork.
The easiest way to find out which tests Medicare covers is to use Medicare’s simple search tool that allows you to type in the type of test to get information on whether it falls under Part B.
Here is a comprehensive list of all tests and screenings that Medicare Part B covers:
Medicare covers many tests and services based on where you live, and the tests we list in this guide are covered no matter where you live. There are some limitations to tests, such as “once in a lifetime” for an abdominal aortic aneurysm screening or every 12 months for mammogram screenings. Medicare will explain all costs for testing and screenings so you understand your responsibility. For example, for a mammogram, you will be responsible for paying 20% of the Original Medicare amount. Medicare has specific pricing for each of its preventive screenings and health tests. Some adults choose a Medicare Advantage Plan or Supplement to further defray the cost of healthcare, including screenings.
“Medicare covers about 80% of what can ever happen, and the 20% that is not covered is why people buy a supplement or Advantage plan,” Cavasini-Esch says. “Most supplements cover 100% with a few deductibles or copays, and any of the Advantage plans can be free, which is very attractive to people who are on a fixed income.”
As for time limits, Cavasini-Esch reminds that Medicare-covered health tests and screenings require a prescription. Prescriptions do not last forever, so be sure to check to see when the prescription expires and get your test before that deadline.
Following is a chart including all Medicare-covered health tests and screenings, what’s covered, how to qualify, test frequency, and out-of-pocket costs.
This expert contributed information and recommendations for this guide.
Karen Cavasini-Esch, Medicare consultant