Does Medicare Cover Quest Labs? 

Having regular check-ups and getting lab work done is essential for maintaining good health throughout life, but it’s even more important for seniors. 

Clinical laboratory diagnostic exams can help physicians with the early detection of health problems so they can be treated more successfully. They also help health care providers track changes in health conditions, and prevent complications related to chronic conditions like diabetes. 

Quest Diagnostics is a clinical laboratory with over 2000 locations in the United States. At Quest, they carry out a great range of diagnostic lab tests that are commonly ordered by health care providers daily. 

If your health care provider orders clinical diagnostic lab work for you, your Medicare insurance should cover your tests if you go to Quest Diagnostics, but here’s a closer look at how to get this coverage. 

Does Medicare cover Quest labs? 

Original Medicare Part B (medical insurance) covers certain clinical diagnostic laboratory tests that your health care provider, who accepts Medicare assignment, orders and certifies as being medically necessary to treat, diagnose, or rule out a medical condition. 

Medicare Part B typically covers the following types of lab tests:

• Blood tests to diagnose or monitor conditions like cholesterol levels, blood cell counts, blood sugar levels, etc. 
• Urinalyses to test for kidney disease, diabetes, urinary tract infections, etc. 
• Tissue specimens to test for cancer or other diseases

Original Medicare Part B also covers certain preventive screening tests annually or bi-annually, depending on your risk factors. These diagnostic lab tests include:

• Pap smear
• HIV screening
• Prostate-specific antigen test
• Fecal occult blood test
• Hepatitis B and C screening
• Colorectal cancer screening

Original Medicare Part B pays 100 percent of the cost for medically necessary clinical diagnostic laboratory exams and preventive screenings if you meet the eligibility requirements. 

Medicare covers testing that’s done at any of the following types of labs if they accept Medicare assignment:

• Physicians’ offices
• Hospital outpatient labs 
• Independent labs like Quest Diagnostics
• Skilled nursing care facility labs
• Labs in other medical institutions

Medicare Advantage (Part C)plans, which are sold by private insurance companies that work with Medicare, are under obligation to cover at least all benefits included in Original Medicare Parts A and B. All Part C plans have the option to include extra benefits and additional coverage, but these benefits vary from plan to plan. 

Depending on the type of Medicare Advantage plan you’ve enrolled in, you may be required to use specific network health care providers, medical facilities, and clinical diagnostic laboratories to get your benefits. 

If your plan has network restrictions for labs, Quest Diagnostics may, or may not, be included in the network. If you aren’t sure, contact your provider for clarification before making appointments for lab tests. 

Most Medicare Advantage plans don’t charge coinsurance for medically necessary clinical diagnostic laboratory tests, but you should review your policy, or ask your health care provider or your plan provider for details to be certain.