Does job-based or Marketplace insurance cover prostate cancer screening?

Often covered, but a PSA test isn’t guaranteed to be $0. PSA screening has a USPSTF “C” rating, so federal law doesn’t require $0 coverage. Many plans and several state laws still cover it without cost sharing; otherwise it’s a lab test subject to your deductible. Cost: May be $0 if your plan or state treats it as preventive; otherwise normal lab cost sharing.

Does Original Medicare cover prostate cancer screening?

Yes, Medicare covers a yearly PSA test at $0 for men over 50. Part B covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the deductible and coinsurance.

Does Medicare Advantage cover prostate cancer screening?

Yes, Medicare covers a yearly PSA test at $0 for men over 50. Part B covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the deductible and coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider. Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.

Does Medicaid cover prostate cancer screening?

Usually covered when ordered. Coverage rules and limits vary by state.

Is prostate cancer screening covered by insurance?

PSA blood test or exam to screen for prostate cancer. Here’s how each kind of plan usually handles it.

Ask a specific question Plan a visit: cost and doctors Check it against my plan

Employer or MarketplaceCovered with conditions
Often covered, but a PSA test isn’t guaranteed to be $0.
More details
PSA screening has a USPSTF “C” rating, so federal law doesn’t require $0 coverage. Many plans and several state laws still cover it without cost sharing; otherwise it’s a lab test subject to your .
Cost: May be $0 if your plan or state treats it as preventive; otherwise normal lab cost sharing.
Original MedicareUsually covered
Yes, Medicare covers a yearly PSA test at $0 for men over 50.
More details
covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the and coinsurance.
Medicare AdvantageUsually covered
Yes, Medicare covers a yearly PSA test at $0 for men over 50.
More details
covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the and coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider.
Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.
MedicaidCovered with conditions
Usually covered when ordered.
More details
Coverage rules and limits vary by state.

Plan type	How it’s usually covered
Employer or MarketplaceCovered with conditions	Often covered, but a PSA test isn’t guaranteed to be $0. PSA screening has a USPSTF “C” rating, so federal law doesn’t require $0 coverage. Many plans and several state laws still cover it without cost sharing; otherwise it’s a lab test subject to your . Cost: May be $0 if your plan or state treats it as preventive; otherwise normal lab cost sharing.
Original MedicareUsually covered	Yes, Medicare covers a yearly PSA test at $0 for men over 50. covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the and coinsurance.
Medicare AdvantageUsually covered	Yes, Medicare covers a yearly PSA test at $0 for men over 50. covers a PSA blood test every 12 months at no cost (a doctor who doesn’t accept assignment may charge for the visit) and a yearly digital rectal exam with the and coinsurance. Medicare Advantage plans must cover Medicare’s preventive services at $0 when you use an in-network provider. Cost: $0 in network for the preventive service; follow-up care can have your plan’s copays.
MedicaidCovered with conditions	Usually covered when ordered. Coverage rules and limits vary by state.

What usually has to be true

Age and frequency rules apply.
Talk with your doctor about whether the test is right for you.

Good to know

Federal $0 coverage applies only to USPSTF A or B services; PSA screening is rated C.

Blood tests & lab work · Blood work, urine tests, and other lab services.
Annual physical · A yearly preventive checkup with your primary care clinician.

Sources

Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.

1
USPSTF A and B recommendations
U.S. Preventive Services Task Force
Services rated A or B by the Task Force, such as specified cancer screenings, PrEP for HIV prevention, and statin use for certain adults, generally must be covered without cost sharing by non-grandfathered plans.
2
Prostate cancer screenings
Medicare.gov
Part B covers a PSA blood test once every 12 months for men over 50 at no cost; digital rectal exams are subject to the deductible and coinsurance.
3
Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
4
Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.

General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.

Is prostate cancer screening covered by insurance?

What usually has to be true

Good to know

Related

Sources