Medicare covers most blood work ordered by your doctor, but you pay a share of the cost depending on which part of Medicare you have and where the test happens.
If your doctor orders blood work as part of a checkup, to diagnose an illness, or to monitor a condition you already have, Medicare Part B typically covers the lab fees. You will not pay anything for the test itself if your doctor is in-network and the lab is Medicare-approved. However, you will owe a copay or coinsurance — usually between $0 and $50 per visit — depending on your plan and whether you have met your deductible.
The exact amount you pay varies based on whether the blood work happens in a doctor's office, a hospital outpatient lab, or an independent lab. Hospital outpatient labs often charge more than independent labs for the same test. If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower or different from Original Medicare.
Key Takeaways
- Medicare Part B covers blood work ordered by your doctor at no charge for the test itself, but you pay a copay or coinsurance based on where the lab is located.
- Hospital outpatient labs typically charge higher copays than independent labs or doctor's offices for the same blood test.
- You will not pay anything if you have not met your Part B deductible and the test is preventive (like a yearly wellness visit blood panel), but you will owe coinsurance for diagnostic or monitoring tests.
- If you have Medicare Advantage or Medigap coverage, your out-of-pocket costs for blood work may be lower than Original Medicare.
- Asking your doctor which lab they use and calling ahead to ask about your copay can help you avoid surprise bills.
What Blood Work Medicare Part B Covers
Medicare Part B covers blood tests that your doctor orders to check your health, find out what is wrong, or keep track of a condition. This includes routine tests like cholesterol panels, glucose tests, and complete blood counts. It also covers blood work done during your yearly wellness visit, which is free under Medicare.
The test must be medically necessary — meaning your doctor has a reason to order it — and the lab must be Medicare-approved. Most labs in the United States are Medicare-approved, including hospital labs, independent labs like LabCorp and Quest Diagnostics, and many doctor's office labs. If you are unsure whether a specific lab is approved, you can ask your doctor or call the lab directly.
Blood work done purely for your own information — such as ancestry testing or wellness screening you pay for out of pocket — is not covered by Medicare. Only tests your doctor orders count.
How Much You Pay Out of Pocket
Under Original Medicare, you pay a copay or coinsurance for blood work after you have met your Part B deductible. The deductible is the amount you must pay out of pocket before Medicare starts to pay its share. Once you meet it, you typically owe 20 percent of the Medicare-approved amount for the test.
The actual copay or coinsurance depends on where the blood work is done. A test at an independent lab might cost you $10 to $20, while the same test at a hospital outpatient lab could cost $30 to $50 or more. Your doctor's office lab falls somewhere in between. These amounts are what you owe after your deductible is met.
If you have a Medigap plan, it may cover some or all of your copay and coinsurance. If you have Medicare Advantage, your copay is usually set by your plan and may be lower than Original Medicare, but you must use in-network labs to get that rate. Out-of-network labs under Medicare Advantage can cost significantly more.
Blood Work During Your Yearly Wellness Visit
Medicare covers a yearly wellness visit at no cost to you, and basic blood work as part of that visit is also free. This includes a lipid panel (cholesterol), glucose test, and other routine screening tests. You do not pay a copay or coinsurance for these tests if they are ordered during your wellness visit and done at a Medicare-approved lab.
However, if your doctor orders additional blood work beyond what is included in the standard wellness panel — for example, because you mention a new symptom — that extra test may not be free. It would be considered diagnostic rather than preventive, and you would owe your usual copay or coinsurance.
Hospital Outpatient Labs Versus Independent Labs
Hospital outpatient labs charge more than independent labs for the same blood test, and Medicare allows them to do so. If your doctor's office is inside a hospital or owned by a hospital, blood work done there will likely cost you more than if your doctor referred you to an independent lab.
You have the right to ask your doctor to send your blood work to an independent lab instead of the hospital lab. Many doctors will do this if you ask, especially if you mention cost. Independent labs like LabCorp and Quest Diagnostics are widely available and often have lower copays. Calling ahead to ask about your copay at different labs can save you money.
Some doctors' offices have their own labs on-site, which may charge less than hospital labs but more than large independent labs. Ask your doctor's office what they charge before the test is done.
What Happens If You Go Out of Network
If you have Original Medicare and use an out-of-network lab, Medicare will still cover the test, but you may pay more. Out-of-network labs can charge higher fees, and you will owe 20 percent of the Medicare-approved amount — which may be less than what the lab actually charges. You could receive a bill for the difference.
To avoid this, ask your doctor whether the lab they use accepts Medicare and is in-network. Most labs do, but it is worth confirming. If you have Medicare Advantage, using an out-of-network lab will almost always cost you more, and some plans may not cover it at all.
How to Reduce Your Blood Work Costs
Ask your doctor which lab they plan to use and whether you can choose a different one. Independent labs are usually cheaper than hospital labs. Call the lab ahead of time and ask what your copay will be, or check your Medicare Summary Notice from a previous visit to see what you paid for similar tests.
If you have not yet met your Part B deductible for the year, ask your doctor whether the blood work can wait until later in the year when you may have already met it. This is not always possible, but for routine monitoring tests it sometimes is. Keep track of what you have paid toward your deductible so you know when you have met it.
If you have a Medigap plan, review your coverage to see whether it covers copays and coinsurance for lab work. If you have Medicare Advantage, check your plan's list of in-network labs and use those to keep costs down.
Frequently Asked Questions
Do I have to pay anything for blood work during my yearly wellness visit?
No. The yearly wellness visit itself is free, and basic blood work ordered as part of that visit — such as a lipid panel or glucose test — is also free. If your doctor orders additional tests beyond the standard panel because of a symptom or concern, you may owe a copay for those extra tests.
What if I get a bill from the lab that is higher than my copay?
Call the lab and ask why. If the lab is out of network or charged more than the Medicare-approved amount, you may owe the difference. Ask the lab to explain the charge and whether it can be adjusted. You can also contact Medicare directly if you believe you were overcharged.
Can I choose which lab my blood work goes to?
Yes. Ask your doctor to send your blood work to a specific lab. Most doctors will do this if you ask. Independent labs often charge less than hospital labs, so mentioning cost may help your doctor agree to refer you elsewhere.
Does Medicare Advantage cover blood work the same way as Original Medicare?
No. Medicare Advantage plans set their own copays and coinsurance amounts, which are often lower than Original Medicare. However, you must use in-network labs to get those rates. Out-of-network labs cost more and may not be covered at all, depending on your plan.
What if my doctor orders blood work that is not medically necessary?
Medicare will not cover tests that are not medically necessary. If your doctor orders a test purely for your own information — such as ancestry testing or a wellness screening you requested — you will pay the full cost out of pocket.