Is a 4Kscore test covered by Medicare?

Medicare does cover 4Kscore tests when it is deemed medically necessary by your doctor. Otherwise, Medicare doesn't cover 4Kscore tests and you'll have to pay nearly $400 out-of-pocket for the test. If the test finds prostate cancer, you'll be able to get Medicare to cover the 4Kscore test and any future treatments.

Free Insurance Comparison

secured lock Secured with SHA-256 Encryption

Chris Tepedino is a feature writer that has written extensively about home, life, and car insurance for numerous websites. He has a college degree in communication from the University of Tennessee and has experience reporting, researching investigative pieces, and crafting detailed, data-driven features. His works have been featured on CB Blog Nation, Flow Words, Healing Law, WIBW Kansas, and C...

Full Bio →

Written by

Laura Walker graduated college with a BS in Criminal Justice with a minor in Political Science. She married her husband and began working in the family insurance business in 2005. She became a licensed agent and wrote P&C business focusing on personal lines insurance for 10 years. Laura serviced existing business and wrote new business. She now uses her insurance background to help educate...

Full Bio →

Reviewed by Laura Walker
Former Licensed Agent Laura Walker

UPDATED: Jan 31, 2022

Advertiser Disclosure

It’s all about you. We want to help you make the right coverage choices.

Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.

Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.

Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.

The Rundown

  • 4Kscore tests are covered if they are deemed medically necessary by your insurer
  • You’ll likely need a PSA test before your insurance will cover a 4Kscore test
  • If you need further tests like a biopsy, Medicare will also cover that

Does Medicare cover 4Kscore tests? If your doctor has deemed it medically necessary, you can get a lot of your prostate tests and exams covered. If you need further services like a biopsy, your health insurance will cover that as long as it’s been deemed medically necessary.

Now that you know Medicare covers 4Kscore tests enter your ZIP code into our free quote tool to see what you could pay to cover your treatments.

Does Medicare cover the 4Kscore test?

Is a 4Kscore test covered by Medicare? If you’re looking to get a Medicare cancer screening, you can likely get it covered, depending on your diagnosis. As an outpatient service covered under Part B Medicare coverage, you’ll need to get a diagnosis from a doctor to prove that it’s medically necessary.

Two tests are covered for diagnosing prostate cancer. Finding something abnormal in these tests serves as a likely reason you’ll need a 4Kscore test. These two tests include:

  • Prostate-specific antigen (PSA)
  • Digital rectal exam (DRE)

If your doctor finds something worth investigating in these tests, they’ll likely recommend that you get a 4Kscore test to screen for prostate cancer.

How much is a 4Kscore test with and without insurance?

4Kscore is a blood test that shows the presence of prostate cancer in your system, and as such, it’s covered under most insurance plans. However, the average cost for the test without insurance sits around $400, according to Medscape. So you likely won’t be charged any additional fees outside of your premium to get the test done with Medicare.

Compare The Best Insurance Quotes In The Country

Compare quotes from the top insurance companies and save!

secured lock Secured with SHA-256 Encryption

Does Medicare cover PSA tests?

Does Medicare pay for a PSA test? If it is deemed a medical necessity, you can quickly get Medicare PSA coverage to help deal with any issues. Furthermore, since it is often a pre-requisite for a 4Kscore test, you’ll need to do this before your insurance considers covering further steps.

If you’re over the age of 55, it’s recommended that you get a regular PSA test to make sure that you don’t have a risk. This is recommended even more heavily for those who have had a close family relationship with someone who has previously developed prostate cancer. Luckily, you can get help through a Medicare PSA without worrying about costs.

What diagnosis covers PSA for Medicare?

Medicare begins paying for PSA testing at age 50, one of the few requirements. Discuss your symptoms of an irritated prostate to your doctor, and they will likely recommend a PSA test. It’s better to be safe than sorry about prostate cancer. Even better is that you don’t have to pay anything for this yearly test.

Does Medicare cover prostate surgery?

If any of the above tests determine that you do have prostate cancer, you’ll likely have to undergo more tests as well as a biopsy to assess the risk it poses. Medicare will pay for these services, but they’ll need to be deemed medically necessary. If you’ve been diagnosed with prostate cancer or your doctor thinks it’s possible, Medicare will cover you.

Does Medicare cover prostate MRIs?

Medicare Part A and B cover any outpatient and inpatient services deemed medically necessary by a doctor. Considering you’ll need a referral to get an MRI in the first place, you’ll likely be able to get this covered under traditional Medicare, as well as any Part C Medicare Advantage plans.

Which Part of Medicare will cover prostate cancer screenings?

Medicare is split into four parts to help better organize billing and coverage limits. Each part will pay for different medical treatments, including:

  • Part A – Covers your inpatient services like hospital stays and any associated medical or tests
  • Part B – helps pay for outpatient services like doctors’ offices and tests done there
  • Part C – Allows private insurers to offer coverage through the Medicare program
  • Part D – covers prescription drugs and vaccines, some medical equipment

Depending on whether you get your diagnosis as an inpatient or outpatient, it’s likely that Part A and B will help pay for your prostate exam cost. In addition, if you have a cancer diagnosis, you can get Medicare genetic testing coverage, as it will be deemed medically necessary as well.

If you have Part C coverage, you may even get further savings. This depends on the private insurance company, which can sometimes be more expensive.

Compare The Best Insurance Quotes In The Country

Compare quotes from the top insurance companies and save!

secured lock Secured with SHA-256 Encryption

Medicare Coverage for the 4Kscore test: The Bottom Line

If you’re worried about having prostate cancer, consider getting a prostate exam and further tests. If your doctor sees the need, you’ll likely be able to get it all covered under your Medicare plan. Since Medicare covers 4Kscore tests if medically necessary, discuss your symptoms with your doctor.

Now that you know Medicare covers 4Kscore tests enter your ZIP code into our free quote tool to see what you would pay to have it covered.

Free Insurance Comparison

Compare quotes from the top insurance companies and save!

secured lock Secured with SHA-256 Encryption