Are Gynecological Exams Covered by Medicare?

Medicare covers Pap smears, pelvic exams, STI testing and HPV screenings. Clinical breast exams are also covered.

How often you can receive these preventive services depends on your medical history and any risk factors.

Cervical cancer and other cancers of the female reproductive organs often have no symptoms.

According to Johns Hopkins University, cervical cancer is more likely to be successfully treated if it is found early.

Screening tests such as Pap smears and pelvic exams can help find abnormal cells that may lead to cancer.

Certain risk factors may qualify you to receive Pap tests and pelvic exams more frequently than once every 24 months.

For Medicare to pay your claim, Pap smears and pelvic exams must be ordered and performed by a doctor, certified nurse-midwife, physician assistant, nurse practitioner or clinical nurse specialist.

You pay nothing for a Pap smear, pelvic exam or breast exam so long as your doctor accepts Medicare.

All copayments and the Part B deductible are waived for these Medicare services.

If your doctor recommends more frequent tests, you may owe a copayment or have other out-of-pocket costs.

Medicare Advantage plans also cover these screenings for women, although you will likely need to see a doctor or other provider in your plan’s network to receive coverage.

Medicare coverage includes a separate test for the human papillomavirus, or HPV. This virus is the main risk factor for cervical cancer.

Any female Medicare beneficiary between the ages of 30 and 65 can receive an HPV screening test once every five years when a Pap smear is performed at the same time.

Medicare Part B covers a Pap smear once every 24 months. The test may be covered once every 12 months if you’re at high risk for cervical cancer or other female-related cancers.

You and your doctor can discuss the benefits and risks of Pap smears and decide what’s best for you.

A Pap smear, also known as a Pap test, is a procedure to check for cervical cancer in women.

It involves collecting cells from your cervix using a soft brush and a flat scraping device called a spatula.

Pap tests can also find problems that aren’t cancer, such as abnormalities and infections.

Medicare coverage of pelvic exams and clinical breast exams is similar to Pap smear coverage.

You can receive one pelvic exam every 24 months. The test may be covered once every 12 months if you’re at high risk for cervical cancer or other female-related cancers.

During a pelvic exam, a doctor evaluates your reproductive organs.

A pelvic exam helps detect precancers, genital cancers, infections, STDs, reproductive system abnormalities and other conditions.

This exam is done in your doctor’s office and takes only a few minutes.

Your doctor may perform a pelvic exam and a breast exam at the same time as your Pap test.

A clinical breast exam is a way to check for signs of breast cancer or other abnormalities.

A breast exam involves a medical professional checking each of your breasts, underarms and your collarbone area for changes in skin texture or breast size.

Your doctor will also feel each of your breasts for any painful areas or lumps.