TSH Blood Test: What Medicare Covers

Health Line

2 days ago

Key takeaways
Original Medicare (parts A and B) and Medicare Advantage (Part C) cover the full cost of a TSH (thyroid-stimulating hormone) test after meeting your deductible.
Medicare Part B generally covers two annual thyroid tests when medically necessary, and may pay for additional testing beyond the first two tests if deemed necessary by your doctor.
The likelihood of developing thyroid function issues (hypothyroidism or hyperthyroidism) increases as you age, making TSH testing particularly relevant for Medicare beneficiaries.
The chances of having a low or high rate of thyroid function — hypothyroidism or hyperthyroidism, respectively — increase as you age, according to a 2019 review.
The TSH hormone regulates the thyroid gland, which controls metabolism and growth. Having too much or too little TSH can negatively affect bodily functions.
A TSH test measures the thyroid-stimulating hormone in your blood, helping identify imbalances. This is especially relevant for Medicare beneficiaries, generally over age 65. Read on to learn when Medicare covers TSH and other thyroid testing.
Does Medicare cover thyroid testing?
Medicare has four parts that cover certain services. Part B is the portion that usually pays for medical, preventive, and diagnostic services. For thyroid testing, Part B generally covers two annual tests when medically necessary, including the TSH test.
Part B may also pay for additional testing beyond the first two tests if deemed medically necessary. Generally, your doctor must certify that the test is medically necessary, and you must get the test from a Medicare-approved laboratory.
If you're covered by Medicare Advantage (Part C), you'll get the same coverage as Original Medicare (parts A and B) from a private insurance plan. That said, your plan may cover additional thyroid testing beyond what Part B covers.
What diagnosis does Medicare require for TSH testing?
Doctors will generally rest your TSH along with the levels of three important thyroid hormones:
triiodothyronine (T3)
thyroxine (T4)
calcitonin
Depending on your results or symptoms, doctors may order additional thyroid screenings. Medically necessary reasons for testing your thyroid include:
telling the difference between primary and secondary hypothyroidism
confirming or ruling out primary hypothyroidism or hyperthyroidism
monitoring thyroid hormone levels if you have goiter, thyroid nodules, or thyroid cancer
tracking the effectiveness of your medication if you have hypothyroidism or hyperthyroidism
In addition, Medicare may cover thyroid testing related to conditions such as:
metabolic disorders
malnutrition
high cholesterol
certain types of anemia
mental health challenges
vision problems,
heart rhythm issues
menstrual disorders
skin conditions
muscle aches
How much does a TSH blood test cost?
You typically won't pay anything out-of-pocket for Medicare-covered laboratory tests as long as your doctor orders the tests and you've met your deductible of $257 in 2025. It's important you ensure that the lab doing the testing accepts Medicare.
Thyroid testing involves taking a blood sample. Your doctor may:
perform the blood test in their office
send you to a specific laboratory
send you to a hospital laboratory
Another cost you still have to account for is your Part B premium, which, in 2025, starts at $185.
On the other hand, each Medicare Advantage (Part C) plan has its own deductible, premium, and copayment rules.
According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans is around $17.00 in 2025. In addition, you'll still be responsible for your Part B premium.
You also may also need to go to an in-network provider or laboratory that accepts both Medicare and your specific Medicare Advantage policy.
If your doctor orders testing more often than the two tests that Medicare coverage allows, you may have to get prior authorization to ensure Medicare coverage.