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Medicare Assignment

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Summary: If a provider accepts Medicare assignment, they accept the Medicare-approved amount for a covered service. Though most providers accept assignment, not all do. In this article, we’ll explain the differences between participating, non-participating, and opt-out providers. You’ll also learn how to find physicians in your area who accept Medicare assignment. Estimated Read Time: 5 min

What is Medicare Assignment

Medicare assignment is an agreement by your doctor or other healthcare providers to accept the Medicare-approved amount as the full cost for a covered service. Providers who “accept assignment” bill Medicare directly for Part B-covered services and cannot charge you more than the applicable deductible and coinsurance.

Most healthcare providers who opt-in to Medicare accept assignment. In fact, CMS reported in its Medicare Participation for Calendar Year 2024 announcement that 98 percent of Medicare providers accepted assignment in 2023.

Providers who accept Medicare are divided into two groups: Participating providers and non-participating providers. Providers can decide annually whether they want to participate in Medicare assignment, or if they want to be non-participating.

Providers who do not accept Medicare Assignment can charge up to 15% above the Medicare-approved cost for a service. If this is the case, you will be responsible for the entire amount (up to 15%) above what Medicare covers.

Below, we’ll take a closer look at participating, non-participating, and opt-out physicians.

Medicare Participating Providers: Providers Who Accept Medicare Assignment

Healthcare providers who accept Medicare assignment are known as “participating providers”. To participate in Medicare assignment, a provider must enter an agreement with Medicare called the Participating Physician or Supplier Agreement. When a provider signs this agreement, they agree to accept the Medicare-approved charge as the full charge of the service. They cannot charge the beneficiary more than the applicable deductible and coinsurance for covered services.

Each year, providers can decide whether they want to be a participating or non-participating provider. Participating in Medicare assignment is not only beneficial to patients, but to providers as well. Participating providers get paid by Medicare directly, and when a participating provider bills Medicare, Medicare will automatically forward the claim information to Medicare Supplement insurers. This makes the billing process much easier on the provider’s end.

Medicare Non-Participating Providers: Providers Who Don’t Accept Assignment

Healthcare providers who are “non-participating” providers do not agree to accept assignment and can charge up to 15% over the Medicare-approved amount for a service. Non-participating Medicare providers still accept Medicare patients. However they have not agreed to accept the Medicare-approved cost as the full cost for their service.

Doctors who do not sign an assignment agreement with Medicare can still choose to accept assignment on a case-by-case basis. When non-participating providers do add on excess charges , they cannot charge more than 15% over the Medicare-approved amount. It’s worth noting that providers do not have to charge the maximum 15%; they may only charge 5% or 10% over the Medicare-approved amount.

When you receive a Medicare-covered service at a non-participating provider, you may need to pay the full amount at the time of your service; a claim will need to be submitted to Medicare for you to be reimbursed. Prior to receiving care, your provider should give you an Advanced Beneficiary Notice (ABN) to read and sign. This notice will detail the services you are receiving and their costs.

Non-participating providers should include a CMS-approved unassigned claim statement in the additional information section of your Advanced Beneficiary Notice. This statement will read:

“This supplier doesn’t accept payment from Medicare for the item(s) listed in the table above. If I checked Option 1 above, I am responsible for paying the supplier’s charge for the item(s) directly to the supplier. If Medicare does pay, Medicare will pay me the Medicare-approved amount for the item(s), and this payment to me may be less than the supplier’s charge.”

This statement basically summarizes how excess charges work: Medicare will pay the Medicare-approved amount, but you may end up paying more than that.

Your provider should submit a claim to Medicare for any covered services, however, if they refuse to submit a claim, you can do so yourself by using CMS form 1490S .

Opt-Out Providers: What You Need to Know

Opt-out providers are different than non-participating providers because they completely opt out of Medicare. What does this mean for you? If you receive supplies or services from a provider who opted out of Medicare, Medicare will not pay for any of it (except for emergencies).

Physicians who opt-out of Medicare are even harder to find than non-participating providers. According to a report by KFF.org, only 1.1% of physicians opted out of Medicare in 2023. Of those who opted out, most are physicians in specialty fields such as psychiatry, plastic and reconstructive surgery, and neurology.

How to Find A Doctor Who Accepts Medicare Assignment

Finding a doctor who accepts Medicare patients and accepts Medicare assignment is generally easier than finding a provider who doesn’t accept assignment. As we mentioned above, of all the providers who accept Medicare patients, 98 percent accept assignment.

The easiest way to find a doctor or healthcare provider who accepts Medicare assignment is by visiting Medicare.gov and using their Compare Care Near You tool . When you search for providers in your area, the Care Compare tool will let you know whether a provider is a participating or non-participating provider.

If a provider is part of a group practice that involves multiple providers, then all providers in that group must have the same participation status. As an example, we have three doctors, Dr. Smith, Dr. Jones, and Dr. Shoemaker, who are all part of a group practice called “Health Care LLC”. The group decides to accept Medicare assignment and become a participating provider. Dr. Smith decides he does not want to accept assignment, however, because he is part of the “Health Care LLC” group, he must remain a participating provider.

Using Medicare’s Care Compare tool, you can select a group practice and see their participation status. You can then view all providers who are part of that group. This makes finding doctors who accept assignment even easier.

To ensure you don’t end up paying more out-of-pocket costs than you anticipated, it’s always a good idea to check with your provider if they are a participating Medicare provider. If you have questions regarding Medicare assignment or are having trouble determining whether a provider is a participating provider, you can contact Medicare directly at 1-800-633-4227. If you have questions about excess charges or other Medicare costs and would like to speak with a licensed insurance agent, you can contact us at the number above.

Announcement About Medicare Participation for Calendar Year 2024, Centers for Medicare & Medicaid Services. Accessed January 2024

https://www.cms.gov/files/document/medicare-participation-announcement.pdf

Annual Medicare Participation Announcement, CMS.gov. Accessed January 2024

https://www.cms.gov/medicare-participation

Does Your Provider Accept Medicare as Full Payment? Medicare.gov. Accessed January 2024

https://www.medicare.gov/basics/costs/medicare-costs/provider-accept-Medicare

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Does Medicare Cover Lab Work?

Medical testing is a routine part of maintaining one’s health. More often than not, the first line of screening for signs of disease or infection may include lab work using blood samples or other bodily fluids. Today’s advanced medical testing equipment and techniques can identify the cause of many diseases using less blood than ever before. Not only does this reduce discomfort for patients, it also allows for faster and more effective treatment.  Common lab work may reduce the need for more invasive diagnostic procedures and expensive scanning tests that often require arduous preparation by the patient.

Does Medicare Cover Lab Work? When ordered by a physician, lab work is generally covered by Medicare Part B. Part B (Medical Insurance) helps cover medically necessary services and care in an outpatient setting, such as a doctor’s office. In order to be covered by Part B, you will need to visit a Medicare-approved physician who accepts assignment and orders the tests in response to diagnose, treat or monitor a condition.

Because of this, lab work that is sought out on your own will likely not be covered. There are many independent labs available that provide a number of the same tests that doctors routinely order, but if you seek out these services on your own, you’ll have to pay out of your own pocket. An exception to this may be when a doctor has ordered lab work at a facility that you aren’t able to access. If a closer alternative is available that can provide the same tests according to your doctor’s orders, then you may be able to appeal.

Individuals enrolled in a Medicare Advantage plan will have at least the same coverage as Medicare Part A and Part B, but many MA plans include additional benefits. Check you’re your specific plan to find out more details regarding lab work coverage.

Does Medicare Cover Lab Work in a Hospital? If you’re formally admitted to a hospital or skilled nursing facility, your services will usually be covered by Medicare Part A (Hospital Insurance). While in a hospital, you will likely need to receive lab testing in order to stabilize, diagnose or treat a condition. If you need to have lab work done after being released from a hospital or medical facility to follow up from your surgery or illness, then Medicare Part B will likely cover the expenses as long as you meet the criteria and visit Medicare-approved facilities.

Do Medicare Deductibles Apply to Lab Work? You will likely be responsible for your annual deductible under Part A and Part B for most lab work services. Any type of medical billing to your Medicare coverage plan may count against your deductible. Medicare Part A and Part B both have different deductible amounts that may change annually. If you have Original Medicare and have purchased a Medicare Supplement (Medigap) policy, your policy may help cover the costs that Original Medicare does not, such as deductibles, copayments, or coinsurance.

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What You Need to Know About Medicare Assignment

If you are one of the more than 63 million Americans enrolled in Medicare and are on the lookout for a new provider, you may wonder what your options are. A good place to start? Weighing the pros and cons of choosing an Original Medicare plan versus a Medicare Advantage plan—both of which have their upsides.

Let’s say you decide on an Original Medicare plan, which many U.S. doctors accept. In your research, however, you come across the term “Medicare assignment.” Cue the head-scratching. What exactly does that mean, and how might it affect your coverage costs?

What is Medicare Assignment?

It turns out that Medicare assignment   is a concept you need to understand before seeing a new doctor. First things first: Ask your doctor if they “accept assignment”—that exact phrasing—which means they have agreed to accept a Medicare-approved amount as full payment for any Medicare-covered service provided to you. If your doctor accepts assignment, that means they’ll send your whole medical bill to Medicare, and then Medicare pays 80% of the cost, while you are responsible for the remaining 20%.

A doctor who doesn’t accept assignment, however, could charge up to 15% more than the Medicare-approved amount for their services, depending on what state you live in, shouldering you with not only that additional cost but also your 20% share of the original cost. Additionally, the doctor is supposed to submit your claim to Medicare, but you may have to pay them on the day of service and then file a reimbursement claim from Medicare after the fact.

Worried that your doctor will not accept assignment? Luckily, 98% of U.S. physicians who accept Medicare patients also accept Medicare assignment, according to the U.S. Centers for Medicare & Medicaid Services (CMS). They are known as assignment providers, participating providers, or Medicare-enrolled providers.

It can be confusing. Here’s how to assess whether your provider accepts Medicare assignment, and what that means for your out-of-pocket costs:

The 3 Types of Original Medicare Providers

1. participating providers, or those who accept medicare assignment.

These providers have an agreement with Medicare to accept the Medicare-approved amount as full payment for their services. You don’t have to pay anything other than a copay or coinsurance (depending on your plan) at the time of your visit. Typically, Medicare pays 80% of the cost, while you are responsible for the remaining 20%, as long as you have met your deductible.

2. Non-participating providers

“Most providers accept Medicare, but a small percentage of doctors are known as non-participating providers,” explains Caitlin Donovan, senior director of public relations at the National Patient Advocate Foundation (NPAF) in Washington D.C. “These may be more expensive,” she adds. Also known as non-par providers, these physicians may accept Medicare patients and insurance, but they have not agreed to take assignment Medicare in all cases. That means they’re not held to the Medicare-approved amount as payment in full. As a reminder, a doctor who doesn’t accept assignment can charge up to 15% more than the Medicare-approved amount, depending on what part of the country you live in, and you will have to pay that additional amount plus your 20% share of the original cost.

What does that mean for you? Besides being charged more than the Medicare-approved amount, you might also be required to do some legwork to get reimbursed by Medicare.

• You may have to pay the entire bill at the time of service and wait to be reimbursed 80% of the Medicare-approved amount. In most cases, the provider will submit the claim for you. But sometimes, you’ll have to submit it yourself.
• Depending on the state you live in, the provider may also charge you as much as 15% more than the Medicare-approved amount. (In New York state, for example, that add-on charge is limited to 5%.) This is called a limiting charge—and the difference, called the balance bill, is your responsibility.

There are some non-par providers, however, who accept Medicare assignment   for certain services, on a case-by-case basis. Those may include any of the services—anything from hospital and hospice care to lab tests and surgery—available from any assignment-accepting doctor, with a key exception: If a non-par provider accepts assignment for a particular service, they cannot bill you more than the regular Medicare deductible and coinsurance amount for that specific treatment. Just as it’s important to confirm whether your doctor accepts assignment, it’s also important to confirm which services are included at assignment.

3. Opt-out providers

A small percentage of providers do not participate in Medicare at all. In 2020, for example, only 1% of all non-pediatric physicians nationwide opted out, and of that group, 42% were psychiatrists. “Some doctors opt out of providing Medicare coverage altogether,” notes Donovan.“In that case, the patient would pay privately.” If you were interested in seeing a physician who had opted out of Medicare, you would have to enter a private contract with that provider, and neither you nor the provider would be eligible for reimbursement from Medicare.

How do I know if my doctor accepts Medicare assignment?

The best way to find out whether your provider accepts Medicare assignment is simply to ask. First, confirm whether they are participating or non-participating—and if they are non-participating, ask whether they accept Medicare assignment for certain services.

Also, make sure to ask your provider exactly how they will be billing Medicare and what charges you might expect at the time of your visit so that you’re on the same page from the start.

Is seeing a non-participating provider who accepts Medicare assignment more expensive?

The short answer is yes. There are usually out-of-pocket costs after you’re reimbursed. But it may not cost as much as you think, and it may not be much more than if you see a participating provider. Still, it could be challenging if you’re on a fixed income.

For example, let’s say you’re seeing a physical therapist who accepts Medicare patients but not Medicare assignment. Medicare will pay $95 per visit to the provider; but your provider bills the service at $115. In most states, you’re responsible for a 15% limiting charge above $95. In this case, your bill would be 115% of $95, or $109.25.

Once you get your $95 reimbursement back from Medicare, your cost for the visit—the balance bill—would be $14.25 (plus any deductibles or copays) .

In some states, the maximum cap on the limiting charge is less than 15%. As mentioned earlier, New York state, for instance, allows only a 5% surcharge, which means that physical therapy appointment would cost you just $4.75 extra.

Bottom line: Medicare assignment providers and non-participating providers who agree to accept Medicare assignment are both viable options for patients. So if you want to see a particular provider, don’t rule them out just because they’re non-par.

While seeing a non-participating provider may still be affordable, ultimately, the biggest headache may be keeping track of claims and reimbursements, or simply setting aside the right amount of money to pay for your visit up front.

Before you schedule a visit, be sure to ask how much the service will cost. You can also estimate the payment amount based on Medicare-approved charges. A good place to start is this  out-of-pocket expense calculator  provided by the CMS.

What if I see a provider who opts out of Medicare altogether?

An opt-out provider will create a private contract with you, underscoring the terms of your agreement. But Medicare will not reimburse either of you for services.

Seeing a provider who does not accept Medicare will likely be more expensive. And your visits won’t count toward your deductible. But you may be able to work out paying reduced fees on a sliding scale for that provider’s services, all of which would be laid out in your contract.

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What is Medicare assignment and how does it work?

Kimberly Lankford,

​Because Medicare decides how much to pay providers for covered services, if the provider agrees to the Medicare-approved amount, even if it is less than they usually charge, they’re accepting assignment.

A doctor who accepts assignment agrees to charge you no more than the amount Medicare has approved for that service. By comparison, a doctor who participates in Medicare but doesn’t accept assignment can potentially charge you up to 15 percent more than the Medicare-approved amount.

That’s why it’s important to ask if a provider accepts assignment before you receive care, even if they accept Medicare patients. If a doctor doesn’t accept assignment, you will pay more for that physician’s services compared with one who does.

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How much do I pay if my doctor accepts assignment?

If your doctor accepts assignment, you will usually pay 20 percent of the Medicare-approved amount for the service, called coinsurance, after you’ve paid the annual deductible. Because Medicare Part B covers doctor and outpatient services, your $240 deductible for Part B in 2024 applies before most coverage begins.

All providers who accept assignment must submit claims directly to Medicare, which pays 80 percent of the approved cost for the service and will bill you the remaining 20 percent. You can get some preventive services and screenings, such as mammograms and colonoscopies , without paying a deductible or coinsurance if the provider accepts assignment. 

What if my doctor doesn’t accept assignment?

A doctor who takes Medicare but doesn’t accept assignment can still treat Medicare patients but won’t always accept the Medicare-approved amount as payment in full.

This means they can charge you up to a maximum of 15 percent more than Medicare pays for the service you receive, called “balance billing.” In this case, you’re responsible for the additional charge, plus the regular 20 percent coinsurance, as your share of the cost.

How to cover the extra cost? If you have a Medicare supplement policy , better known as Medigap, it may cover the extra 15 percent, called Medicare Part B excess charges.

All Medigap policies cover Part B’s 20 percent coinsurance in full or in part. The F and G policies cover the 15 percent excess charges from doctors who don’t accept assignment, but Plan F is no longer available to new enrollees, only those eligible for Medicare before Jan. 1, 2020, even if they haven’t enrolled in Medicare yet. However, anyone who is enrolled in original Medicare can apply for Plan G.

Remember that Medigap policies only cover excess charges for doctors who accept Medicare but don’t accept assignment, and they won’t cover costs for doctors who opt out of Medicare entirely.

Good to know. A few states limit the amount of excess fees a doctor can charge Medicare patients. For example, Massachusetts and Ohio prohibit balance billing, requiring doctors who accept Medicare to take the Medicare-approved amount. New York limits excess charges to 5 percent over the Medicare-approved amount for most services, rather than 15 percent.

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How do I find doctors who accept assignment?

Before you start working with a new doctor, ask whether he or she accepts assignment. About 98 percent of providers billing Medicare are participating providers, which means they accept assignment on all Medicare claims, according to KFF.

You can get help finding doctors and other providers in your area who accept assignment by zip code using Medicare’s Physician Compare tool .

Those who accept assignment have this note under the name: “Charges the Medicare-approved amount (so you pay less out of pocket).” However, not all doctors who accept assignment are accepting new Medicare patients.

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What does it mean if a doctor opts out of Medicare?

Doctors who opt out of Medicare can’t bill Medicare for services you receive. They also aren’t bound by Medicare’s limitations on charges.

In this case, you enter into a private contract with the provider and agree to pay the full bill. Be aware that neither Medicare nor your Medigap plan will reimburse you for these charges.

In 2023, only 1 percent of physicians who aren’t pediatricians opted out of the Medicare program, according to KFF. The percentage is larger for some specialties — 7.7 percent of psychiatrists and 4.2 percent of plastic and reconstructive surgeons have opted out of Medicare.

Keep in mind

These rules apply to original Medicare. Other factors determine costs if you choose to get coverage through a private Medicare Advantage plan . Most Medicare Advantage plans have provider networks, and they may charge more or not cover services from out-of-network providers.

Before choosing a Medicare Advantage plan, find out whether your chosen doctor or provider is covered and identify how much you’ll pay. You can use the Medicare Plan Finder to compare the Medicare Advantage plans and their out-of-pocket costs in your area.

Return to Medicare Q&A main page

Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at  Kiplinger’s Personal Finance  and has written for  The Washington Post  and  Boston Globe . She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.

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Medicare Assignment: Understanding How It Works

Medicare assignment is a term used to describe how a healthcare provider agrees to accept the Medicare-approved amount. Depending on how you get your Medicare coverage, it could be essential to understand what it means and how it can affect you.

What is Medicare assignment?

Medicare sets a fixed cost to pay for every benefit they cover. This amount is called Medicare assignment.

You have the largest healthcare provider network with over 800,000 providers nationwide on Original Medicare . You can see any doctor nationwide that accepts Medicare.

Understanding the differences between your cost and the difference between accepting Medicare and accepting Medicare assignment could be worth thousands of dollars.

Doctors that accept Medicare

Your healthcare provider can fall into one of three categories:

Medicare participating provider and Medicare assignment

Medicare participating providers not accepting medicare assignment, medicare non-participating provider.

More than 97% of healthcare providers nationwide accept Medicare. Because of this, you can see almost any provider throughout the United States without needing referrals.

Let’s discuss the three categories the healthcare providers fall into.

Participating providers are doctors or healthcare providers who accept assignment. This means they will never charge more than the Medicare-approved amount.

Some non-participating providers accept Medicare but not Medicare assignment. This means you can see them the same way a provider accepts assignment.

You need to understand that since they don’t take the assigned amount, they can charge up to 15% more than the Medicare-approved amount.

Since Medicare will only pay the Medicare-approved amount, you’ll be responsible for these charges. The 15% overcharge is called an excess charge. A few states don’t allow or limit the amount or services of the excess charges. Only about 5% of providers charge excess charges.

Opt-out providers don’t accept Original Medicare, and these healthcare providers are in the minority in the United States. If healthcare providers don’t accept Medicare, they won’t be paid by Medicare.

This means choosing to see a provider that doesn’t accept Medicare will leave you responsible for 100% of what they charge you. These providers may be in-network for a Medicare Advantage plan in some cases.

Avoiding excess charges

Excess charges could be large or small depending on the service and the Medicare-approved amount. Avoiding these is easy. The simplest way is to ask your provider if they accept assignment before service.

If they say yes, they don’t issue excess charges. Or, on Medicare.gov , a provider search tool will allow you to look up your healthcare provider and show if they accept Medicare assignment or not.

Medicare Supplement and Medicare assignment

Medigap plans are additional insurance that helps cover your Medicare cost-share . If you are on specific plans, they’ll pay any extra costs from healthcare providers that accept Medicare but not Medicare assigned amount. Most Medicare Supplement plans don’t cover the excess charges.

The top three Medicare Supplement plans cover excess charges if you use a provider that accepts Medicare but not Medicare assignment.

Medicare Advantage and Medicare assignment

Medicare assignment does not affect Medicare Advantage plans since Medicare Advantage is just another way to receive your Medicare benefits. Since your Medicare Advantage plan handles your healthcare benefits, they set the terms.

Most Medicare Advantage plans require you to use network providers. If you go out of the network, you may pay more. If you’re on an HMO, you’d be responsible for the entire charge of the provider not being in the network.

Do all doctors accept Medicare Supplement plans?

All doctors that accept Original Medicare accept Medicare Supplement plans. Some doctors don’t accept Medicare. In this case, those doctors won’t accept Medicare Supplements.

Where can I find doctors who accept Medicare assignment?

Medicare has a physician finder tool that will show if a healthcare provider participates in Medicare and accepts Medicare assignments. Most doctors nationwide do accept assignment and therefore don’t charge the Part B excess charges.

Why do some doctors not accept Medicare?

Some doctors are called concierge doctors. These doctors don’t accept any insurance and require cash payments.

What is a Medicare assignment?

Accepting Medicare assignment means that the healthcare provider has agreed only to charge the approved amount for procedures and services.

What does it mean if a doctor does not accept Medicare assignment?

The doctor can change more than the Medicare-approved amount for procedures and services. You could be responsible for up to a 15% excess charge.

How many doctors accept Medicare assignment?

About 97% of doctors agree to accept assignment nationwide.

Is accepting Medicare the same as accepting Medicare assignment?

No. If a doctor accepts Medicare and accepts Medicare assigned amount, they’ll take what Medicare approves as payment in full.

If they accept Medicare but not Medicare assignment, they can charge an excess charge of up to 15% above the Medicare-approved amount. You could be responsible for this excess charge.

What is the Medicare-approved amount?

The Medicare-approved amount is Medicare’s charge as the maximum for any given medical service or procedure. Medicare has set forth an approved amount for every covered item or service.

Can doctors balance bill patients?

Yes, if that doctor is a Medicare participating provider not accepting Medicare assigned amount. The provider may bill up to 15% more than the Medicare-approved amount.

What happens if a doctor does not accept Medicare?

Doctors that don’t accept Medicare will require you to pay their full cost when using their services. Since these providers are non-participating, Medicare will not pay or reimburse for any services rendered.

Get help avoiding Medicare Part B excess charges

Whether it’s Medicare assignment, or anything related to Medicare, we have licensed agents that specialize in this field standing by to assist.

Give us a call, or fill out our online request form . We are happy to help answer questions, review options, and guide you through the process.

Related Articles

• What are Medicare Part B Excess Charges?
• How to File a Medicare Reimbursement Claim?
• Medicare Defined Coinsurance: How it Works?
• Welcome to Medicare Visit
• Guide to the Medicare Program

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Insurance List: Carriers Currently Filed by Labcorp

Insurance coverage plays a crucial role in healthcare, ensuring that individuals can access necessary medical services without facing exorbitant costs. Labcorp, a renowned healthcare diagnostics company, collaborates with various insurance carriers to offer comprehensive coverage to patients. In this article, we will explore the insurance carriers filed by Labcorp, providing an overview of the options available to individuals seeking medical services.

Understanding Labcorp

Labcorp, also known as Laboratory Corporation of America Holdings, is a leading global life sciences company specializing in diagnostics and drug development. Their extensive network of laboratories provides a wide range of medical tests and services. To ensure patient accessibility, LabCorp works closely with numerous insurance carriers to establish agreements and facilitate seamless coverage.

Insurance Carriers Filed by Labcorp

• Blue Cross Blue Shield: Blue Cross Blue Shield (BCBS) is a prominent insurance provider that offers coverage in various states across the United States. Labcorp has established partnerships with multiple BCBS plans, enabling individuals with BCBS insurance to access Labcorp’s services for diagnostic tests, screenings, and other medical procedures.
• UnitedHealthcare: UnitedHealthcare is one of the largest health insurance providers in the United States. Through its extensive network, Labcorp has collaborated with UnitedHealthcare to ensure that policyholders can conveniently access Labcorp’s diagnostic facilities and services.
• Aetna: As a subsidiary of CVS Health, Aetna is a well-known insurance company that offers healthcare coverage to millions of individuals. Labcorp has partnered with Aetna, allowing Aetna policyholders to benefit from Labcorp’s wide range of diagnostic tests and services.
• Cigna: Cigna is a global health services company that provides insurance coverage to individuals and businesses. Labcorp has established agreements with Cigna, making Labcorp’s diagnostic services easily accessible to Cigna policyholders.
• Humana: Humana is a leading healthcare company that offers a range of insurance plans, including Medicare Advantage and commercial plans. Labcorp has collaborated with Humana, ensuring that Humana policyholders can access Labcorp’s diagnostic services for their healthcare needs.
• Anthem: Anthem, Inc. is a prominent health insurance provider operating in several states across the United States. Labcorp has partnered with Anthem, allowing Anthem policyholders to access Labcorp’s comprehensive range of diagnostic tests and services.
• Medicare: Medicare is a federal health insurance program primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities. Labcorp accepts Medicare coverage, ensuring that eligible individuals can avail themselves of Labcorp’s diagnostic services.
• Medicaid: Medicaid is a joint federal and state program that provides health coverage to low-income individuals and families. Labcorp works with Medicaid programs in various states, offering essential diagnostic services to Medicaid beneficiaries.

Labcorp’s collaboration with multiple insurance carriers ensures that individuals can access necessary medical services without financial burdens. By partnering with major insurance providers such as Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana, Anthem, Medicare, and Medicaid, Labcorp extends its reach and facilitates easy access to its comprehensive range of diagnostic tests and services. This comprehensive insurance list demonstrates Labcorp’s commitment to making healthcare more accessible to individuals across different insurance plans.

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Diagnostic laboratory tests

Medicare Part B (Medical Insurance) covers medically necessary clinical diagnostic laboratory tests, when your doctor or provider orders them.  These tests may include certain blood tests, urinalysis, certain tests on tissue specimens, and some screening tests.

Your costs in Original Medicare

You usually pay nothing for Medicare-covered clinical diagnostic laboratory tests.  

Diagnostic laboratory tests look for changes in your health and help your doctor diagnose or rule out a suspected illness or condition.  

Things to know

Medicare also covers some preventive tests and screenings to help prevent or find a medical problem.  

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If you do not have insurance you will have to pay for the tests performed by Labcorp before specimen collection services are performed.

• An automated payment collection process is available at many of our patient service centers, as well as certain doctors' offices where a phlebotomist (person who performs blood draws) is on site to perform specimen collection services for Labcorp.
• Certain routine tests are available at discounted prices through the LabAccess Partnership program. To take advantage of this program, you must have your specimen collected at a Labcorp patient service center, and you must pay for your test in full at the time of service.

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Please visit here to find a list of insurances filed by Labcorp.  Select a State in the drop-down menu to view the PDF.

If your health care benefits do not cover clinical laboratory testing services, you will have to pay for the tests performed by Labcorp before specimen collection services are performed.

• An automated payment collection process is available at many of our patient service centers, as well as certain doctor’s offices where a phlebotomist (person who performs blood draws) is on site to perform specimen collection services for Labcorp.

If you have received an Explanation of Benefits (EOB) from your insurance company that shows different information than the bill you received from Labcorp, please forward a copy of your EOB to Labcorp. You may fax this information to 866-227-2939 (toll free) or mail a copy of the EOB to:

Please allow your insurance company four to six weeks to process your claim.

Labcorp relies on the ordering physician to submit the diagnosis code information at the time of the test order.  Please contact your physician's office if your insurance company denied a claim due to the diagnosis code.

You should have received an Explanation of Benefits (EOB) from your insurance company that explains in detail the services as either paid or denied. If you need further assistance determining the reason(s) why your insurance company did not pay for your services, please contact your insurance carrier directly for information about its coverage policies.

If you are covered by more than one commercial insurance plan, your primary insurer will process your claim first, and then any remaining balance will be billed to the secondary insurer. If you receive a bill from Labcorp before you receive an Explanation of Benefits (EOB) from your secondary insurance, please contact Patient Billing at 800-845-6167 to confirm your secondary insurance information was received and a claim was filed.

Please read your bill carefully. A line-item adjustment will be printed on the first bill you receive from Labcorp if we have received payment from your insurance company. If you are still uncertain, you can either contact your insurance company directly or contact Labcorp Patient Billing at 800-845-6167 .

Using an in-network provider can help maximize your healthcare benefits and can help minimize your out-of-pocket costs. You should check with your insurance provider to see if Labcorp is a contracted laboratory provider.

Labcorp will file claims directly to Medicare, Medicaid, and many insurance companies and managed care plans. Before you have lab tests performed, please make sure:

• Your insurance information is up to date.
• Labcorp is a contracted laboratory for your insurance company. Contact your insurance company for information.

Once your insurer has processed your claim, you will receive an Explanation of Benefits (EOB) from your insurer informing you of the amount it will pay for your laboratory services.

• The EOB is not a bill, but it may indicate that a balance remains which is your responsibility. That balance may include your copayment, deductible, or other costs outlined in your terms of coverage. If you have a question about your EOB or your terms of coverage, contact your insurance company.
• Your insurer will inform Labcorp about any balance you owe, and we will send you a bill for that amount.

Frequently Asked Questions

Billing & Insurance

• General Information (7)
• Insurance (11)
• Online Payments (3)
• Payment Programs (8)
• All FAQs for Billing & Insurance (29)

Labs & Appointments

• Labcorp PreCheck (8)
• Appointments (3)
• Locations (3)
• All FAQs for Labs & Appointments (14)

Testing Information

• Getting Tested (6)
• Getting Results (4)
• Understanding Results (1)
• All FAQs for Testing Information (11)

Labcorp Patient portal

• Test Results (4)
• All FAQs for Labcorp Patient portal (5)

• Company Information (4)
• Labcorp Careers (13)
• Labcorp.com Support (4)
• All FAQs for General (21)

Managing Your Health

• Shop for Health Tests
• Explore Women's Health
• Annual Wellness Guidelines

Diseases & Therapeutic Areas

• Cancer & Oncology
• Rheumatology

Treatment Modalities & Methods

• Cell & Gene Therapies
• Precision Medicine

Scientific Lab Disciplines

• Genetics & Genomics
• Diagnostic Reference & Specialty Labs
• Nonclinical Labs
• Central Labs
• Crop & Agricultural
• Chemical & Environmental

• Resource Center

Individuals & Patients

Appointments & Locations

• Search Test Menu
• New & Updated Tests
• Provider Portal Login

Health Systems & Organizations

• Managed Care Portal Login
• Diseases & Conditions
• Educational Resources

View Biopharma

• Order Trial Test Kit
• Print UPS Label

Find Locations

Payment Programs

Yes. Labcorp makes it easy to pay any balance owed by presenting your credit card or health care savings account (HSA) card when you check into a Labcorp lab location (patient service center) to have a specimen collected. For more about the Sign & Go Preauthorized Credit Card Option, visit here and scroll to the bottom.

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You will not receive a notification from Labcorp prior to your card being charged. You will receive a confirmation letter after your card has been charged. The letter will include the dollar amount charged, the date the card was charged, and the confirmation number.

Your credit/health savings account card information is safe with us. Labcorp secures this data and protects it within our network. We have adopted payment card industry security standards, and we will destroy your card information after a charge has been processed or your insurance company has notified us that you are not responsible for any charges.

LabCorp makes available discounted fees on a menu of routine clinical tests for patients who are uninsured or whose health care benefits do not cover clinical laboratory testing.

The LabAccess Partnership (LAP) program is available for self-pay patients who are uninsured or whose health benefits exclude coverage for clinical laboratory testing services.

Patients must present their test request paperwork at a Labcorp patient service center for specimen collection. To take advantage of the LabAccess Partnership (LAP) program, patients must pay the discounted fees of the ordered laboratory tests in full at the time of service. Patients with unpaid laboratory charges will not be eligible for the program until overdue balances are satisfied.

Yes, alternate payment programs are available and must be set up by a patient billing representative, who is trained to assist patients with their payment questions and is available from 8 AM to 5 PM Monday through Friday at 800-845-6167 .

Labcorp offers programs to assist those patients who have true financial needs, including:

• Patient-specific payment plans
• Special payment plans for financial hardship
• Indigent request from physician/facility
• LabAccess Partnership program

For additional information about these programs, click here or call Labcorp Patient Billing at 800-845-6167 .

Frequently Asked Questions

Billing & Insurance

• General Information (7)
• Insurance (11)
• Online Payments (3)
• Payment Programs (8)
• All FAQs for Billing & Insurance (29)

Labs & Appointments

• Labcorp PreCheck (8)
• Appointments (3)
• Locations (3)
• All FAQs for Labs & Appointments (14)

Testing Information

• Getting Tested (6)
• Getting Results (4)
• Understanding Results (1)
• All FAQs for Testing Information (11)

Labcorp Patient portal

• Test Results (4)
• All FAQs for Labcorp Patient portal (5)

• Company Information (4)
• Labcorp Careers (13)
• Labcorp.com Support (4)
• All FAQs for General (21)