Does Medicare cover blood tests for cholesterol?

Published by Medicare Made Clear®

For people watching their cholesterol, routine screening blood tests are important. Medicare Part B generally covers a screening blood test for cholesterol once every five years. You pay nothing for the test if your doctor accepts Medicare assignment and takes Medicare’s payment as payment in full.

If you are diagnosed with high cholesterol, Medicare may cover additional services. Medicare will typically cover medically necessary blood work used to help monitor your condition and how you respond to treatment, as well as any necessary doctor visits or outpatient tests related to managing your cholesterol.

What is the blood test screening for cholesterol?

A complete blood test for cholesterol is called a full lipid profile. The results help your doctor monitor your heart health and detect conditions that may lead to a heart attack or stroke.

A full lipid profile measures the following:

  • Total cholesterol
  • Lipids (HDL and LDL)
  • Triglycerides

Your doctor may want you to have your cholesterol tested more often, depending on your health needs. For example, you may need more frequent tests if you are diagnosed with high cholesterol or you have other heart disease risks.

Medicare coverage for additional blood tests

Medicare Part B may help pay for additional blood tests for cholesterol if your doctor orders them. You’ll still be responsible for 20 percent of the Medicare-approved cost (coinsurance) if you have Original Medicare (Parts A & B).

If you have a Medicare Advantage plan (Part C), check with your plan to learn about coverage for additional cholesterol tests and what the cost would be.

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