Does Medicare Cover Thyroid Tests?

Medicare Part B does cover thyroid tests and other blood tests when considered medically necessary and ordered by a doctor.

Medicare Advantage (Part C) plans also cover thyroid tests when they’re medically necessary. Most Medicare Advantage plans also offer prescription drug coverage and an annual out-of-pocket spending limit.

Original Medicare (Part A and Part B) doesn’t typically cover prescription drugs and doesn’t include out-of-pocket spending limits.

What lab tests does Medicare cover?

Medicare Part B (medical insurance) covers lab tests such as blood test, urinalysis, skin or tissue testing and some other lab tests when ordered by a doctor and considered medically necessary.

Two common thyroid function tests are the total thyroxine (T4) test and the serum thyroid stimulating hormone (TSH) test.

• The T4 test is used to help evaluate thyroid function and diagnose thyroid diseases, including hypothyroidism (the thyroid gland doesn't produce enough thyroid hormone) and hyperthyroidism (overactivity of the thyroid gland).
  
  
• The TSH test measures how much of the thyroid stimulating hormone (TSH) is in your blood. This lab test helps determine whether your thyroid gland is working the way it should.

How much does Medicare pay for thyroid tests?

If your thyroid test is covered by Medicare Part B, you typically pay 20 percent of the Medicare-approved amount of the test after you meet your Part B deductible.

In 2019, the Medicare Part B deductible is $185 per year.

Does Medicare cover thyroid medications?

If you are prescribed thyroid medication to help treat your condition, you may be responsible for 100 percent of the cost of the drug if you only have Medicare Part A and Part B.

Medicare Part D prescription drug plans and Medicare Advantage plans that offer prescription drug coverage may help cover your thyroid medication, however.

Be sure to check with your plan carrier to find out whether or not your plan covers your thyroid medication, as well as the out-of-pocket costs involved.

Many Medicare Advantage plans offer additional benefits

Medicare Advantage plans cover everything that Original Medicare covers (including thyroid tests), and most plans include coverage for prescription drugs.

Additionally, some Medicare Advantage plans offer additional benefits such as:

• Dental coverage
• Vision coverage
• Hearing coverage
• Health and wellness benefits, such as SilverSneakers membership

A licensed insurance agent can help you look for Medicare Advantage plans in your area that cover thyroid tests.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.