Medicare typically covers a lipid panel once every 5 years for routine screening in asymptomatic individuals, but can cover it annually or more frequently (up to six times the first year, then three times yearly once stable) for monitoring known high cholesterol, treatment changes (diet/medication), or borderline levels, as it's considered medically necessary testing for treatment rather than screening. Coverage depends on the reason for the test, with providers assigning specific codes to justify the frequency.
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 pays for an annual wellness visit, but not routine blood work. You can get regular screenings for specific conditions if you meet Medicare's eligibility requirements.
People over age 40 should get a lipid panel annually, and they should ask to have it added to annual blood work if their primary care physician doesn't order it – since it is easily overlooked with the plethora of other issues being maintained, Farbaniec said.
The optimal interval for screening is uncertain. Reasonable options include every 5 years, shorter intervals for people who have lipid levels close to those warranting therapy, and longer intervals for those not at increased risk who have had repeatedly normal lipid levels.
Medicare Part B covers an annual wellness exam and many preventive screenings with no copay or deductible. However, you may have to pay a share of the cost for certain recommended tests or services. And while it's not mandatory, there are very good reasons to have a wellness exam every year.
How often can you get lab tests? Most plans offer coverage for preventive screening once a year (under ACA requirements), but for some tests, your plan may only cover tests performed at longer intervals, such as every other year.
If you are eligible for a medication review service, the Pharmacist may determine a clinical need to provide a cholesterol test as part of the service. In these cases, the test is provided at no charge. Without a medication review service, a fee of $35 may apply.
Part B covers up to 2 blood glucose (blood sugar) laboratory test screenings each year if your doctor determines you're at risk for developing diabetes. These screenings may be fasting or non-fasting glucose tests, A1C tests, or other glucose tests approved by Medicare as appropriate.
Medicare does not cover blood tests when they aren't medically necessary. If your doctor orders a blood test to diagnose, prevent, or treat a condition, Medicare will cover the blood test.
Medicare generally does not cover routine, wellness, or self-requested blood tests without clear medical necessity, such as tests for employment, most genetic panels, or extensive vitamin/micronutrient panels, but it does cover medically necessary lab work ordered by a doctor to diagnose, treat, or prevent a specific condition, including certain screenings. Key non-covered areas include routine bloodwork during Annual Wellness Visits, tests for third parties, and extensive "wellness panels," with coverage hinging on your doctor documenting a specific medical reason.
Here are some of the biggest Medicare mistakes to avoid:
The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025.
Once every 12 months.
Eye tests. Medicare covers eye tests done by an optometrist: once every 3 years if you're under 65 years. once a year if you're 65 years or older.
Part B covers blood glucose (sugar) meters and related supplies (like test strips and lancets), continuous glucose monitors, and durable insulin pumps. There may be limits on how much or how often you get these supplies. 20% of the Medicare-approved amount after you meet the Part B deductible.
Medicare does not provide routine coverage for lipid disorders unless there is an established diagnosis. While components of the lipid panel, such as total cholesterol or LDL, may be covered up to six times in the first year for therapy monitoring, routine testing without a diagnosis is not supported.