Does Medicare Cover Pap Smears? 

Pap smears are screening procedures that help physicians diagnose or rule out the presence of cervical cancer. Most physicians recommend that women between the ages of 21 and 65 have regular Pap smears and tests for human papillomavirus (HPV) at the same time. 

During a Pap screening procedure, a health care provider takes a sample of cells from your cervix. A lab technician examines it for abnormal cell growth that can signal cancerous or precancerous conditions. 

Today in the United States, cervical cancer is most commonly diagnosed in women who are between 35 and 44 years old. However, over 20 percent of all cases of cervical cancer are discovered after the age of 65, and typically in people who didn’t have regular screenings before reaching this age. 

If cervical cancer is detected early, there is a higher chance of successful treatment and a positive outcome.

How does Medicare cover Pap smears? 

Original Medicare Part B (medical insurance) covers 100 percent of the cost of Pap smears and pelvic exams once every 24 months. These screening exams are part of Medicare’s preventive care services for the detection of cervical and vaginal cancers. 

You are eligible for a Pap smear screening every 24 months for as long as you and your health care provider feel they are necessary. In many cases, doctors stop ordering routine Pap smears for women over age 65 if they’ve had three normal Pap smears (in a row) within the past 10 years, or if they’ve had two normal Pap-HPV combination screenings in a row within the past 10 years.  

You should continue to get a routine Pap smear after age 65 if you have a history of cervical cancer or lesions, your mother took diethylstilbestrol (a synthetic form of estrogen) during pregnancy, or if you have a weak immune system. 

If you meet the following eligibility requirements, Medicare may cover a Pap smear every 12 months:

1. You’re of childbearing age and have had an abnormal Pap screen within the past 36 months
2. You’re at high risk for cervical or vaginal cancer because of the following:
3. You had sex before age 16
4. You’ve had several sex partners 
5. You’ve had sexually transmitted illnesses (STIs)
6. You haven’t had a Pap smear
7. Your mother took DES while she was pregnant

Original Medicare Part B also covers Human Papillomavirus (HPV) screenings in combination with a Pap smear one time every five years if you are between 30 and 65 years old, and you don’t have symptoms of HPV. You may be eligible for more frequent testing if you have symptoms of HPV. 

Original Medicare Part B pays 100 percent of the cost for the following tests if your physician and the diagnostic laboratory accept Medicare assignment:

• Pap test specimen collection 
• Pelvic exam
• Diagnostic lab work for a Pap test
• Diagnostic lab work for an HPV and Pap test combination

How does Medicare Advantage cover Pap smears?

If you’re enrolled in a Medicare Advantage (Part C) plan, your provider must cover all the benefits included in Original Medicare Parts A and B. However, depending on the type of MA coverage you have, you may need to have your Pap smear and other preventive care screenings done by health care providers who are included in your plan’s network of approved providers to qualify for coverage. Your MA plan may charge you a copayment or coinsurance amount for your screenings. Check with your provider if you aren’t sure what charges to expect.