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% of the cost of the PSA test (with no Part B deductible required) and 80% 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% of the cost and the patient or their supplemental insurance is responsible for the other 20%.
Medicare Advantage Plans cover all preventive services the same as Original Medicare. This means Medicare Advantage Plans will not be allowed to charge cost-sharing fees (coinsurances, copays or deductibles) for preventive services that Original Medicare does not charge for as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.