What Medicare covers
| Screening | How often | What you pay |
|---|---|---|
| PSA blood test | Once every 12 months, men over 50 | Nothing for the test |
| Digital rectal exam | Once every 12 months, men over 50 | 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026) |
If you get the rectal exam in a hospital outpatient department, you may also owe a hospital copayment. Medigap policies pay all or part of the coinsurance. People on Medicare because of a disability who are over 50 are covered the same way.
When screening turns into diagnosis
If a screening result is abnormal, the tests that follow, such as a repeat PSA ordered for a problem, an MRI or a biopsy, are diagnostic. Part B covers medically necessary diagnostic tests and treatment, including surgery, radiation and drug therapy given in a doctor's office, with the usual deductible and coinsurance. Prostate cancer drugs you take at home are generally covered by your Part D plan or a Medicare Advantage plan with drug coverage; check the plan's formulary.
Deciding whether to screen
Medicare covers the yearly screening whether or not you choose to have it. The U.S. Preventive Services Task Force's current recommendation (from 2018, now being updated) is that men 55 to 69 make an individual decision with their clinician about PSA screening, and it advises against routine PSA screening at 70 and older. Talk with your doctor about your own risk, including family history. The yearly Wellness visit is a good time to ask.
Getting screened in Oregon
Any clinic or lab that accepts Medicare and draws blood can do a PSA test. To avoid surprise bills, ask whether the provider accepts Medicare assignment. If you have a Medicare Advantage plan, use an in-network clinic and lab. You can find doctors who accept Medicare with Medicare's care compare tool, or see how to find Medicare doctors in Oregon.
Related questions
Does Medicare cover colonoscopy in Oregon?
Colorectal cancer screening.
Does Medicare cover annual physicals in Oregon?
Wellness visits versus physicals.
Does Medicare cover bone density tests in Oregon?
Another preventive test.
Sources
- Medicare.gov — Prostate cancer screenings
- U.S. Preventive Services Task Force — Prostate cancer: screening
- Medicare.gov — Care Compare
More questions in this guide
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- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
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- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
Why was I billed after a $0 PSA test?
The test is covered at no cost, but if your provider doesn't accept assignment you may owe a fee for the provider's services, and a separate office visit on the same day can have its own cost sharing.
Is a prostate MRI or biopsy covered?
When your doctor orders it because of symptoms or an abnormal result, it is diagnostic care under Part B, so the deductible and coinsurance apply.
Does Medicare Advantage cover prostate screening?
Yes. Medicare Advantage plans must cover the same preventive screenings, and in-network preventive services that Original Medicare covers at no cost are generally at no cost in the plan too.
Medicare in your Oregon county
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