Does Medicare Cover the HPV Test? (2026)

Direct Answer: What Medicare Covers for the HPV Test in 2026

Yes. Medicare Part B covers the HPV co-test once every 5 years for beneficiaries ages 30 to 65 with no HPV symptoms. Part B pairs the HPV test with a Pap smear, and covers this combination at $0 copay, $0 coinsurance, with the deductible waived, when the provider accepts Medicare assignment and bills the visit as preventive. If ordered as diagnostic instead of preventive, standard 20% Part B cost-sharing applies after the 2026 deductible of $283.

What Original Medicare Covers: Screening Schedule and Rules

Original Medicare Part B covers two distinct cervical cancer screening benefits. The first is a standalone Pap smear, covered once every 24 months for most beneficiaries. The second is the HPV co-test, where an HPV test is performed alongside a Pap smear, covered once every 5 years for beneficiaries ages 30 to 65 with no HPV symptoms. Both benefits are fully covered at $0 when billed as preventive services by a provider who accepts Medicare assignment.

High-risk beneficiaries get accelerated coverage. If you are at high risk for cervical or vaginal cancer, or if you are of childbearing age and had an abnormal Pap result within the past 36 months, Medicare covers the Pap smear every 12 months instead of every 24 months. The CMS National Coverage Determination 210.2.1 governs the HPV-specific rules and was formally added in 2015 when CMS expanded coverage to include HPV co-testing as a preventive service for asymptomatic women. Medicare beneficiaries over age 65 can continue to receive Pap smears on the standard schedule even though many clinical guidelines suggest stopping routine screening around age 65, because Medicare coverage does not cut off at 65 for this benefit.

What Medicare Advantage May Add in 2026

Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including the preventive HPV co-test at $0. Beyond that floor, some plans offer additional women's health benefits such as lower out-of-pocket costs for gynecological visits, broader coverage for follow-up colposcopies or biopsies, or value-added benefits like telehealth consultations with OB-GYN providers. Coverage details vary by plan, so review the Summary of Benefits for your specific Medicare Advantage plan each year.

During the Medicare Advantage Open Enrollment Period (January 1 through March 31, 2026), you can make one switch between Medicare Advantage plans if your current plan's women's health benefits do not meet your needs. The Annual Enrollment Period (October 15 through December 7, 2026) is the main window for switching plans, with coverage starting January 1, 2027. Use the Plan Finder tool at medicare.gov to compare cervical cancer screening benefits across plans in your area.

Preventive vs. Diagnostic HPV Testing: A Critical Billing Distinction

The $0 cost applies only when the HPV test is billed as a preventive screening service. If your provider orders an HPV test because you have current symptoms, because an abnormality was found on a recent Pap smear, or for any reason other than routine screening within the covered frequency limits, the test is billed as a diagnostic service. In that case, standard Part B cost-sharing applies: you pay 20% coinsurance after the 2026 Part B deductible of $283 has been met for the year.

A common billing pitfall: if your provider schedules a routine preventive Pap smear and HPV co-test but then discusses a medical problem during the same visit, the entire visit may be re-billed as a problem-focused evaluation and management (E&M) visit rather than a preventive visit. That shift converts your $0 preventive service into a visit with cost-sharing. To avoid this, schedule preventive screenings as standalone appointments and address other medical concerns at a separate visit. If you receive an unexpected bill for a preventive HPV test, ask the billing office to review the diagnosis code used.

2026 Guideline Update: HPV Testing as the Preferred Screening Method

On January 5, 2026, the Health Resources and Services Administration (HRSA) adopted updated Women's Preventive Services Initiative (WPSI) guidelines designating high-risk HPV testing as the preferred cervical cancer screening method for average-risk women ages 30 to 65. The updated guidelines also recommend that women be offered the option to self-collect their cervical sample at home rather than visiting a clinician. Under the ACA, private insurance plans must cover newly recommended preventive services within one plan year after adoption, meaning most private plans must cover at-home HPV collection starting January 1, 2027.

Medicare operates under separate rules from private insurance. Medicare's HPV coverage is governed by the CMS National Coverage Determination (NCD 210.2.1), which must be updated through a formal CMS rulemaking process before any expanded coverage takes effect for Medicare beneficiaries. As of May 2026, CMS has not yet updated the NCD to reflect the new HRSA guidelines or to add self-collection HPV testing as a covered Medicare service. Medicare beneficiaries should monitor cms.gov for any NCD updates in 2026 or early 2027.

Cost Without Coverage and Standalone Supplemental Options

For Medicare beneficiaries who fall outside the standard coverage criteria (for example, someone under 30 or with a diagnostic rather than preventive test need), the out-of-pocket cost of an HPV test in 2026 ranges from approximately $50 to $200 at a lab, depending on whether it is ordered as a standalone test or paired with a Pap smear. Many federally qualified health centers (FQHCs) and Title X family planning clinics offer HPV testing on a sliding-fee scale based on income, which may result in little to no cost for low-income patients. Community health centers accept Medicare, Medicaid, and uninsured patients.

For beneficiaries with both Medicare and Medicaid (dual-eligible), Medicaid fills gaps in Medicare's cost-sharing. For diagnostic HPV tests where Part B charges 20% coinsurance after the 2026 deductible of $283, Medicaid typically covers that remaining cost-sharing for dual-eligible beneficiaries, making the effective cost $0. Approximately 12 million Americans are dual-eligible. Medigap (Medicare Supplement) plans cover Part B coinsurance for diagnostic services, though Medigap is not needed for the preventive HPV co-test since Part B already covers it at $0. Note that Medicare Part A (hospital insurance) and Medicare Part D (prescription drug coverage) do not cover HPV testing, which is a Medicare Part B preventive service billed through outpatient care. The HPV test is classified as an ACA-required women's preventive service, which is why ACA-compliant plans and Medicare Part B cover it without cost-sharing.

How to Get Your HPV Test Covered by Medicare: Step-by-Step

Getting the $0 preventive HPV test through Medicare requires a few straightforward steps. First, confirm your provider accepts Medicare assignment, because providers who do not accept assignment can charge above Medicare's allowed amount, potentially leaving you with an unexpected balance. You can verify assignment status at medicare.gov or by calling 1-800-MEDICARE. Second, when scheduling, explicitly tell the scheduling staff you want a routine preventive Pap smear and HPV co-test. Using the word 'preventive' in your request helps ensure the visit is coded correctly.

Does Original Medicare cover the HPV test?

Yes. Medicare Part B covers the HPV co-test (HPV test performed with a Pap smear) once every 5 years for beneficiaries ages 30 to 65 with no HPV symptoms. There is no copay, no coinsurance, and the deductible is waived when the provider accepts Medicare assignment and bills the visit as preventive.

Does Medicare cover the HPV test for women over 65?

Medicare's preventive HPV co-test coverage is specified for ages 30 to 65. For beneficiaries over 65, routine Pap smears continue to be covered once every 24 months as a standard preventive benefit. Whether to continue HPV co-testing after age 65 is a clinical decision between you and your provider; if ordered diagnostically after 65, standard Part B cost-sharing applies (20% after the 2026 deductible of $283).

What does the HPV test cost with Medicare in 2026?

The preventive HPV co-test (ages 30-65, no symptoms, within the 5-year frequency) costs $0 when your provider accepts Medicare assignment. If the HPV test is ordered as a diagnostic service, standard Part B cost-sharing applies: 20% of the Medicare-approved amount after the 2026 Part B deductible of $283. Many Medigap plans cover that 20% coinsurance for diagnostic visits.

Does Medicare Advantage cover the HPV test?

Yes. All Medicare Advantage (Part C) plans must cover the preventive HPV co-test at the same terms as Original Medicare, which means $0 cost for ages 30 to 65 without symptoms once every 5 years. Some Medicare Advantage plans may include additional women's health benefits beyond the Part B floor. Review your plan's Summary of Benefits or call the member services number on your plan card to confirm coverage details.

How often does Medicare cover the HPV test?

Medicare Part B covers the HPV co-test once every 5 years for average-risk beneficiaries ages 30 to 65. Pap smears (without the HPV co-test) are covered once every 24 months for most beneficiaries or every 12 months for those at high risk or with a recent abnormal Pap result within the past 36 months. The two benefits are tracked separately.

Does Medicare cover an HPV test if I have symptoms or an abnormal Pap result?

Yes, but as a diagnostic service rather than a preventive one. When an HPV test is ordered because of symptoms or as follow-up to an abnormal screening result, Medicare Part B covers it as medically necessary. Standard Part B cost-sharing applies: you pay 20% coinsurance after the 2026 annual deductible of $283. If you have Medigap or dual-eligibility through Medicaid, those programs typically cover the 20% coinsurance.

Does Medicare cover the new at-home HPV test?

Not yet for Medicare beneficiaries. In January 2026, HRSA updated its Women's Preventive Services Guidelines to include self-collected at-home HPV testing as an option for average-risk women ages 30 to 65. Private insurance plans must cover this starting January 1, 2027. However, Medicare's HPV coverage is governed by a separate CMS National Coverage Determination (NCD 210.2.1), which had not yet been updated to include at-home collection as of May 2026. Check cms.gov for any NCD updates.

What is the difference between a Pap smear and an HPV co-test?

A Pap smear (Pap test) checks cervical cells directly for abnormal changes that could indicate cancer or precancer. An HPV co-test adds an HPV DNA test to the same cervical sample to detect the presence of high-risk HPV strains that cause cervical cancer. Medicare covers a standalone Pap smear every 24 months and the HPV co-test (Pap plus HPV together) every 5 years for ages 30 to 65. Medical professional societies currently recommend the HPV co-test as the preferred approach over a Pap-only test for the 30 to 65 age group.