Does Medicare cover genetic testing?

A genetic test is a medical test that checks for changes in your DNA. A sample of DNA is typically taken through blood, saliva or a cheek swab and tested in a laboratory. The results can help diagnose a genetic condition or show your risk of getting or passing on a genetic disorder.¹ 

Medicare covers a range of diagnostic genetic tests if they’re FDA-approved and ordered by a treating physician. Some examples of covered tests include:

• Diagnostic tests for specific symptoms: If you have symptoms of a possible genetic disorder, Medicare may cover testing to confirm a diagnosis. 
• Pharmacogenomics: This testing helps doctors understand how your body processes medications so they can prescribe the best drug and dosage. 
• Next Generation Sequencing (NGS): For patients with advanced cancer, NGS can help identify mutations that might respond to targeted therapies. 
• Colorectal cancer screenings: Part B will cover a multi-target stool DNA test every 3 years if you’re 45–85 years old, show no symptoms of colorectal disease and are at average risk of developing colorectal cancer.²

Which genetic tests does Medicare not cover?

There are several genetic tests that Medicare doesn’t cover, such as: 

• Ancestry testing: Tests used to determine heritage or family tree information.  
• General screening: Tests done only to predict the risk of developing a disease in the future, without any current symptoms or a diagnosis of cancer.  
• Direct-to-consumer tests: Kits bought online or at a store without a doctor's order. 

Does Medicare cover genetic testing for cancer? 

Medicare covers genetic testing for cancer in many situations. For example, Medicare covers tests for hereditary breast or ovarian cancer (including BRCA1 and BRCA2 mutations) if your personal or family history suggests a genetic link. Medicare will also cover testing for Lynch syndrome, an inherited condition that increases the risk of certain cancers.

How much does a genetic test cost with Medicare? 

If your genetic test is covered by Part B, you typically pay nothing for the test itself. However, you may still have to pay the standard Part B deductible ($283 in 2026) and 20% coinsurance for the doctor's visit.

How can I check if Medicare will cover my genetic test? 

Here are some ways to verify coverage for genetic testing:  

1. Talk to your doctor: Ask if the test is medically necessary and if your doctor will accept Medicare assignment. 
2. Contact Medicare: Call 1-800-MEDICARE (1-800-633-4227).  
3. Check with the lab: Make sure the laboratory doing the test accepts Medicare. 
4. Review your plan: If you have a Medicare Advantage Plan (Part C) , contact your plan provider directly.

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