Medicare covers many of the tests performed at Quest Diagnostics, as long they’re medically necessary, and the Quest facility you’re using accepts Medicare.
Quest Diagnostics is one of the largest providers of outpatient testing in the world. The company has more than 2,000 locations in the United States alone.
Keep reading to learn more about Medicare coverage for tests from Quest Diagnostics.
Medicare Part B, part of Original Medicare with Part A, generally covers medically necessary diagnostic tests. On the other hand, Part A only covers tests ordered by your doctor during your stay in a hospital or skilled nursing facility.
To get Part B coverage for a test done specifically at a Quest clinic, you must ensure the particular location participates in Medicare, as each U.S. state has its own regulations for Medicare facilities.
You can check whether Medicare covers the Quest Diagnostics near you by using this map.
Medicare Advantage
If you’re insured by Medicare Advantage (Part C), you’ll get the same benefits as you would with Original Medicare, including any testing that Medicare Part B covers.
That said, many Medicare Advantage plans have networks whose providers may differ from those approved for Original Medicare. Therefore, you must stay in the network for testing to receive full coverage. If you go to an out-of-network doctor or facility, you’ll pay a much higher price — or your test might not be covered.
Quest Diagnostics is in-network for many major providers of Medicare Advantage plans, including:
- Aetna
- Anthem (most plans)
- Blue Cross Blue Shield (most plans)
- Cigna
- Humana
- UnitedHealthcare
You can check with your plan to see whether the Quest Diagnostics location near you is part of the network.
Medicare defines “medically necessary” as “healthcare services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms that meet accepted standards of medicine.”
In general, this is the case if your doctor suspects you may have a condition or are at risk of such a condition based on your symptoms, examination, or family history.
Check out the table below for some of the most common covered tests. Unless otherwise noted, most tests are only covered once a year.
| Type of test | Reason (frequency) |
|---|---|
| Blood tests and screenings | • diabetes (covered up to twice a year) • heart disease (covered every 5 years) • HIV • hepatitis • STIs • prostate cancer • colon cancer |
| Urinalysis tests | can help diagnose many conditions, including kidney and liver disease |
| Specimen tests | • fecal occult blood tests to screen for colon cancer • tissue sample biopsies to screen for multiple cancer types |
| Other screenings | • cervical cancer • vaginal cancer • bone mass measurements to screen for osteoporosis (covered every 2 years) • lung cancer screenings |
Coding guide
As long as your qualifying test is ordered by a doctor accepting Medicare, MedicarePart Bwill cover it. But, not all Quest Diagnostics locations offer every test or screening procedure covered by Medicare.
Check with your local Quest facility to make sure it can provide the test your doctor has ordered. You can also search online in Quest’s Coding Guide to see if your specific test is offered and covered by Medicare.
If Quest Diagnostics doesn’t offer the test you need, your doctor might also be able to recommend other local laboratories that do.
If you’re unsure or have additional questions about your coverage, you can call Medicare directly at 800-MEDICARE (TTY: 877-486-2048).
The cost of your test without insurance will depend on the test and the facility where you do it.
That said, Part B should fully cover the test cost if it is approved as medically necessary and after you’ve met the annual Part B deductible of $257. You must also pay your monthly premium, which starts at $185 in 2025.
On the other hand, if you are covered by a Medicare Advantage (Part C) plan, your deductible and premium will depend on your specific plan. According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans will be around $17.00 in 2025.
Note that if you go to a Quest location that doesn’t accept Medicare, you’ll need to pay for the test completely out of pocket, even if Medicare covers it.
You can use Medicare at Quest Diagnostics to get coverage for a wide range of tests your doctor might order as long as:
- your doctor and the Quest location you use participate in Medicare
- the test you’re getting is medically necessary
You can check with your doctor, your local Quest Diagnostics facility, or Medicare to ensure your test will be covered.
If you’ve already met your plan’s annual deductible, you typically won’t pay any out-of-pocket costs for testing.