One question that often arises is whether Medicare covers lab services. Lab services may include blood tests, urine tests, and other diagnostic testing or screenings. This blog post will summarize whether or not Medicare covers lab services and how much coverage seniors receive for these services.
To get started, let’s cover the basics of what Medicare does and doesn’t cover, as well as how you can get coverage for your lab tests if your doctor orders them.
What Types of Lab Work Are Covered by Medicare?
Medicare covers a wide range of lab work, including blood tests to check cholesterol levels and liver function, or urinalysis to screen for infection or diabetes. Medicare will also cover diagnostic testing, such as X-rays and CT scans, when medically necessary.
If your physician orders a lab test, Medicare Part B will cover this service. If you are an inpatient in a hospital setting, then Medicare Part A will provide this coverage. With this in mind, it’s important that you know which part of Medicare will cover what in specific settings. This will help you better prepare for the out-of-pocket costs you may or may not have to cover.
Your Deductibles
For Part A, you will have a deductible per each benefit period of $1,484 as of 2021. This benefit period starts when you are admitted as an inpatient. You won’t have to pay coinsurance for days 1 through 60, but if your inpatient stay is longer than that, you should expect to pay a coinsurance. For example, during days 61 through 90, you’ll have a daily $371 coinsurance.
For Part B, you will have an annual $203 deductible. Once you meet this deductible, you will cover about 20% of the Medicare-approved amount for the services you receive.
Parts A and B
Now that you know what costs you can expect, let’s further discuss the coverage of these two parts. Medicare Part A covers inpatient care in a hospital or a skilled nursing facility. It also provides coverage for hospice care, some home health services, and typically includes room and board as well as general nursing services. Medicare Part B covers a wide range of medical and outpatient services, from routine doctor visits to durable medical equipment. In short, Part B will cover medically necessary and preventative services.
Overall, seniors need to know what services are covered by Medicare and what costs they can expect before enrolling in the program.
What’s Not Covered?
Some lab tests are not covered by Medicare – if you want these types of tests done, you may need to pay out-of-pocket. These services include anything that is not deemed medically necessary by your doctor or other healthcare provider. If you have concerns about your health or want to ensure you receive appropriate coverage for any necessary test, consult with your doctor before proceeding.
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With all of the changes that go into effect over time, you need someone who understands what’s covered and how this impacts you and your out-of-pocket costs. That’s why we are the experts when it comes to understanding Medicare coverage. Give us a call today if you want help navigating through these waters!