Does Medicare Cover Blood Tests?
Blood testing has been around since the 1930s, but medical scientists have been experimenting with blood for hundreds of years before that. As early as the 1600s, blood transfusions were performed despite no knowledge of blood typing. In 1901, blood typing was discovered, and decades later, blood testing became common among doctors in the examination of diseases.
Today, blood testing is a routine medical procedure that is generally handled during outpatient visits to a doctor’s office or a lab. Blood is usually collected via a hollow needle and syringe that removes a small portion from the body to be analyzed by special equipment, test strips and chemical agents. Using blood tests, doctors can diagnose certain diseases, but they can also discover information about a patient’s overall health.
Does Medicare cover blood tests?
Blood tests are run on people of all ages, but seniors may wonder whether Original Medicare benefits apply toward the cost of blood tests. In most cases, Medicare does cover blood work, but how the program provides benefits for blood tests depends largely on how and where the blood work is performed.
Medicare coverage through Part B, the outpatient portion of Original Medicare, covers blood tests that take place in a clinical setting like a doctor’s office or outpatient lab or clinic. This is the most common location for blood to be drawn, and the blood is then either sent to a lab for analysis or it is examined at an on-site lab. Part B covers 80% of the cost of blood tests. Medicare recipients will need to meet the deductible and maintain your premium payments in order for benefits to apply.
Medicare coverage for inpatient blood work
If you have blood drawn for testing while you’re admitted to a hospital or skilled nursing facility, the testing is considered a part of your inpatient treatment as long as the services are being provided by the staff of the facility. In these cases, Medicare benefits under Part A apply toward coverage. What should be noted about Medicare Part A is that it will only provide up to 60 days of 100% coverage per benefit period. From day 61 through day 90, you can continue to receive Medicare coverage at a discounted rate, and from day 91 onward, you can utilize lifetime reserve days.
Prescription drug coverage and blood testing
Medicare Part D provides prescription drug coverage, so it does not apply toward the cost of blood tests; however, it may supply coverage for prescription drugs that are prescribed as a result of blood test results. If your doctor finds something in your blood that requires medicinal intervention, your Part D coverage will provide benefits as long as the drugs you are prescribed are listed in your plan’s formulary.
Coverage depends on where you have blood work done
Something to keep in mind is that Medicare recipients can only take advantage of coverage when blood is drawn and tested through a facility that is approved by Medicare. There are a number of companies out there that provide walk-in lab work, including blood testing, and these companies are usually independent and not affiliated with a doctor’s office or hospital.
If you visit one of these facilities on your own to have your blood tested, you will want to ensure that the facility is approved by Medicare prior to your appointment. If the facility is not, you will be responsible for 100% of the cost of your blood work regardless of your Medicare plan or benefits.
If you’re enrolled in a Medicare Advantage plan, you may need to visit labs or medical providers within the plan’s network. If you go outside the plan’s network, you may be responsible for the full cost of your blood work.