Yes, Medicare covers Pap smears after 65, but the frequency depends on your screening history

Original Medicare (Part B) covers a Pap smear once every three years if you have a cervix, regardless of age. If you are 65 or older and have never had a Pap smear, or if it has been more than three years since your last one, Medicare covers the test at no cost to you — you pay nothing for the screening itself, though you may owe a copay if additional services are performed during the same visit.

The key detail: Medicare stops covering routine Pap smears at age 65 only if you have had adequate prior screening with normal results. "Adequate" means regular Pap smears over the previous 10 years with no abnormal findings. If your screening history is incomplete or unknown, your doctor can order a Pap smear and Medicare will cover it.

If you are on a Medicare Advantage plan (Part C), coverage rules may differ slightly — some plans cover Pap smears more frequently or with different cost-sharing. Check your plan documents or call the plan directly to confirm what you owe.

Key Takeaways

  • Medicare Part B covers one Pap smear every three years at no cost if you have a cervix, even after age 65.
  • If you have had regular normal Pap smears for the past 10 years, Medicare may not cover additional routine screening after 65.
  • If your screening history is incomplete or you have not had a Pap smear in more than three years, Medicare will cover one.
  • Medicare Advantage plans may have different coverage rules, so review your plan or call your insurer to confirm your costs.

When Medicare stops covering routine Pap smears

Medicare's coverage rule reflects medical guidance: if you have had regular Pap smears with normal results, the risk of cervical cancer drops significantly. At age 65, if your doctor confirms you have had adequate screening (typically three consecutive normal Pap smears within the past 10 years), Medicare considers further routine screening unnecessary and will not cover it.

This does not mean you cannot have a Pap smear after 65 — it means Medicare will not pay for it as a routine screening. If your doctor orders one for a medical reason (such as abnormal symptoms or follow-up to a previous abnormal result), Medicare may cover it as a diagnostic test rather than a screening.

What "adequate prior screening" means

Adequate prior screening typically means you have had at least three normal Pap smear results in a row, with the most recent one within the past 10 years. If you have a documented history of normal results, your doctor can note this in your medical record, and Medicare will use that documentation to determine whether routine screening is covered.

If you do not have records of your past Pap smears, or if you moved and your previous results are not available, tell your doctor. They can order a Pap smear and Medicare will cover it because your screening history cannot be confirmed as adequate. Once you have a normal result on file, future routine screening decisions will be based on that baseline.

How to learn about your screening is covered

Before your appointment, call your doctor's office and ask them to check your screening history. They can tell you whether Medicare will cover a Pap smear based on your records. If they are unsure, they can contact Medicare directly or check your records against what Medicare has on file.

You can also call Medicare at 1-800-MEDICARE and provide your name and date of birth. Medicare staff can tell you whether a Pap smear is covered under your specific situation. Have your insurance card handy when you call.

If you are on a Medicare Advantage plan, call the plan's customer service number (on the back of your card) instead. They will tell you whether the Pap smear is covered and what you will owe.

What you pay if Medicare covers the Pap smear

If Medicare covers the Pap smear as a screening, you pay nothing for the test itself. You do not owe a deductible or copay for the screening portion of the visit.

However, if your doctor performs other services during the same visit — such as a pelvic exam, blood work, or treatment for an abnormal result — you may owe a copay for those additional services. Ask your doctor's office in advance what services will be performed and what your costs will be.

What happens if Medicare does not cover it

If your doctor determines that a Pap smear is not medically necessary based on your screening history, and Medicare does not cover it, you have the option to pay out of pocket. Many community health centers and Planned Parenthood locations offer Pap smears on a sliding fee scale based on income, which may cost less than the full price.

Before you pay out of pocket, ask your doctor whether the test is truly not covered or whether there is a medical reason to order it (such as symptoms or a previous abnormal result). If there is a medical reason, Medicare may cover it as a diagnostic test even if routine screening is not covered.

Medicare Advantage and other plan variations

If you are enrolled in a Medicare Advantage plan, your coverage may differ from Original Medicare. Some plans cover Pap smears more frequently than every three years, or they may have different cost-sharing arrangements. Review your plan's Summary of Benefits and Coverage document, which lists what screenings are covered and what you owe.

If you have both Medicare and Medicaid (called "dual may be able to access"), Medicaid may cover services that Medicare does not, including additional Pap smears. Contact your state Medicaid office or your plan to learn what is covered under both programs.

Frequently Asked Questions

Can I get a Pap smear after 65 if I have never had one before?

Yes. If you have never had a Pap smear or your screening history is unknown, Medicare will cover one. Your doctor may recommend starting screening even at 65 if you have never been screened, and Medicare will cover it.

What if I had abnormal Pap smear results in the past?

If you have a history of abnormal results, your doctor may recommend more frequent screening or follow-up testing. Medicare will cover these as medically necessary tests, even after 65. Bring documentation of your previous abnormal results to your appointment.

Does Medicare cover HPV testing along with a Pap smear?

Yes, if your doctor orders HPV testing as part of cervical cancer screening, Medicare covers it. Some doctors now use HPV testing alone or in combination with a Pap smear. Ask your doctor which test or combination is right for you.

What if I am on Medicare and still working with employer health insurance?

Your employer plan is primary and should cover the Pap smear. Medicare becomes secondary. Check your employer plan's coverage first, then contact Medicare if you have questions about coordination of benefits.

Can I get a Pap smear at a community health center or Planned Parenthood with Medicare?

Yes, as long as the provider accepts Medicare. Call ahead to confirm they accept your Medicare plan and to schedule an appointment. Bring your Medicare card with you.