Medicare coverage of prostate cancer screenings

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Last Update: January 30, 2012

Prostate cancer screenings can detect early prostate cancer. Medicare covers one prostate screening a year (every 12 months) for all male Medicare patients age 50 and older. This screening includes a Prostate-Specific Antigen (PSA) blood test and a digital rectal exam (DRE).

Medicare covers 100 percent of the cost of the PSA test (with no Part B deductible required) and 80 percent of the cost of the digital rectal exam (after you pay your annual Part B deductible). You will have no copay or deductible for the PSA test if you see doctors who accept assignment. Doctors and other health care providers who accept assignment cannot charge you more than the Medicare approved amount.

Medicare will cover these services more than once a year if your doctor says you need them for diagnostic purposes. If an exam is considered diagnostic, Medicare covers 80 percent of the cost and the patient or their supplemental insurance is responsible for the other 20 percent.

If you are in a Medicare Advantage plan (private health plan) you should call your plan to see what costs and rules apply.


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American Cancer Society

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