Medicare typically covers the cost of thyroid tests if a doctor deems them necessary. These diagnostic tools allow the healthcare professional to determine whether someone has thyroid gland problems.
The thyroid gland, located in the neck, produces hormones that regulate metabolism. If an individual has a thyroid condition, they may experience weight control issues or cardiovascular complications.
Thyroid dysfunction happens when the thyroid gland makes too much or too little thyroid hormone. This includes hypothyroidism and hyperthyroidism.
This article explores thyroid dysfunction and discusses how Medicare covers thyroid and other blood tests. It also examines treatments and therapies for thyroid dysfunction and costs.
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part A covers the cost of inpatient stays in a hospital, clinic, or other nursing facilities. Medicare Part B covers medically necessary services in an outpatient setting, doctor’s visits, and prevention services, including diagnostic and blood tests.
Generally, Medicare covers thyroid testing under Part B as long as a doctor orders it to diagnose or treat a medical condition. Specifically, Part B typically covers two annual tests when deemed medically necessary. It may, sometimes, approve additional tests when certified as medically necessary by your doctor and conducted at a Medicare-approved lab.
However, Part A will cover the cost if a person is in a hospital or nursing facility and a doctor orders a thyroid test during their inpatient stay. Medicare Part A also covers the cost if the doctor recommends surgical removal of the thyroid gland.
Medicare Advantage plans
People who get coverage through a Medicare Advantage (Part C) plan will get the same coverage as from Original Medicare (parts A and B, but from a private insurance plan. That said, their plan may cover additional thyroid testing beyond what Part B covers.
According to Debt.org, the cost of a thyroid test ranges between $97 and $195 out-of-pocket. This varies according to the laboratory and the location.
Though Medicare covers most clinical diagnostic tests, including thyroid tests, a person will generally have some costs, as shown below.
Medicare Part B
Medicare Part B covers the total cost of thyroid tests. However, a person must meet the annual deductible of $257. Other costs include the basic Part B monthly premium, which is $185 in 2025.
Medicare Part A
If a doctor orders a thyroid test while an inpatient, Medicare Part A covers the cost after the patient has met their deductible. The Part A deductible is $1,676 in 2025 for each benefit period, which starts as soon as the patient enters the hospital and continues for 60 days.
Medicare Advantage plans
Costs for Advantage plans differ. In addition to paying the standard Part B premium, a person enrolled in an Advantage plan will pay the plan premium. According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans is around $17.00 in 2025.
Most people have zero costs for Medicare-covered clinical diagnostic tests, including thyroid tests. However, if a person needs help covering the costs of thyroid treatment, they may find assistance from Medigap or Medicaid.
Medigap
A Medigap plan helps a person enrolled in Medicare pay out-of-pocket costs such as copays, deductibles, and coinsurance that Medicare does not cover. Private insurance companies offer 10 Medigap plans with different levels of coverage.
A person must be enrolled in Original Medicare to be eligible to enroll in a Medigap plan. This means a person cannot enroll in Medigap if they are insured by Medicare Advantage (Part C).
Medicaid
Medicaid helps low-income, low-resource households to access healthcare services. The government funds this program, and individual states set the eligibility criteria for income and assets.
What lab tests are not covered by Medicare?
Generally speaking, Medicare may not cover a lab test if it is not medically necessary.
Is a TSH test considered preventive?
A TSH test measures the thyroid-stimulating hormone in the blood. Typically, it is not a preventive test, as a doctor orders it to diagnose thyroid imbalances based on symptoms.
The thyroid gland is a small gland in the neck that produces hormones that control metabolism and growth. People can experience problems if they produce too much or too little thyroid hormones.
Original Medicare (Part A and Part B) and Medicare Advantage plans offer the same level of coverage for thyroid tests. Medicare Part B covers the cost of an outpatient blood test, while Medicare Part A covers the cost of a thyroid blood test as part of an inpatient hospital stay.
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