Humana does cover blood work under its Medicare Advantage, commercial, and Medicaid plans. What you pay depends on three things: whether the test is preventive or diagnostic, whether the lab is in your plan’s network, and which plan you carry. Preventive screenings are generally free. Many Humana Medicare Advantage plans cover lab services at $0 even beyond the preventive list. Diagnostic tests on commercial plans may involve a deductible or coinsurance.
Preventive Blood Tests You Pay Nothing For
Federal law requires Medicare and ACA-compliant plans to cover a defined set of preventive screenings at no out-of-pocket cost when you use an in-network provider. Because Humana Medicare Advantage plans must cover everything Original Medicare covers, members can get these blood tests without a copay, coinsurance, or deductible.
On the Medicare side, the no-cost blood-based screenings include cardiovascular disease screening (cholesterol, lipid, and triglyceride levels every five years), diabetes screening (up to two screenings a year for eligible beneficiaries), the PSA prostate cancer screening once every 12 months for men over 50,1Medicare.gov. Your Guide to Medicare Preventive Services hepatitis B and C screening for people at risk, HIV screening once every 12 months for adults 15 to 65, and colorectal cancer screening that includes an annual fecal occult blood test and a blood-based biomarker test every three years for adults 45 to 85.2Medicare.gov. Preventive Screening Services
If you’re on a Humana marketplace or employer plan rather than Medicare, the Affordable Care Act requires a comparable set of no-cost preventive tests through in-network providers, including cholesterol screening, type 2 diabetes screening for overweight or obese adults aged 40 to 70, hepatitis B and C screening, HIV screening, and syphilis screening for higher-risk adults.3HealthCare.gov. Preventive Care Benefits for Adults
Humana Medicaid plans also cover preventive blood work. Humana Healthy Horizons in Indiana, for example, says all preventive care visits, including diabetes screening and wellness screenings, are paid for by the plan.4Humana. Preventative Care – Humana Healthy Horizons in Indiana
What Blood Work Costs Under Medicare Advantage
Many Humana Medicare Advantage plans go further than the preventive mandate and cover lab services broadly at no cost. The 2026 Humana Group Medicare Advantage PPO plan offered through the Kentucky Public Pensions Authority lists lab services at 0% cost-sharing for both in-network and out-of-network providers, whether the draw happens at a primary care office, specialist office, urgent care center, freestanding lab, or outpatient hospital.5Humana. Humana Group Medicare Advantage PPO – 2026 Summary of Benefits
The 2026 Humana Group Medicare Advantage HMO plan offered through the State of Louisiana similarly lists a $0 copay for lab services across all provider settings.6State of Louisiana Office of Group Benefits. Humana Group Medicare Advantage HMO Plan – 2026 Summary of Benefits The Humana Gold Plus Integrated plan in Illinois, a Medicare-Medicaid dual plan, also puts lab tests at a $0 copay.7Humana. Humana Gold Plus Integrated Plan – Summary of Benefits
Even when lab work itself carries no cost-sharing, the office visit or other services on the same day may apply to a deductible. The Kentucky PPO plan has a $500 annual medical deductible for some services, though lab work itself is exempt. Plan specifics vary, so check your own Summary of Benefits or Evidence of Coverage.
Costs on Employer and Commercial Plans
Humana employer plans that are not Medicare Advantage follow a similar pattern with different cost structures. A Humana non-Medicare PPO plan offered through Michigan State University covers lab work at no charge in-network, with the deductible waived for those services. Out-of-network lab work costs 20% coinsurance after the deductible is met.8Michigan State University. Humana MSU Non-Medicare PPO – Summary of Benefits and Coverage
One trap to watch for on commercial plans: even an in-network doctor may send your samples to an out-of-network lab for processing. The MSU plan document specifically tells members to confirm the lab before getting blood work drawn so you don’t get an out-of-network bill.
Preventive Versus Diagnostic, and the Annual Wellness Visit
The difference between preventive and diagnostic matters more than any other distinction for what you’ll pay. A preventive test screens a person without symptoms for a condition on the covered list. A diagnostic test investigates a symptom or monitors a known condition. Preventive is free; diagnostic may carry a copay or coinsurance depending on your plan.
This is where the Medicare Annual Wellness Visit confuses people. Humana covers the yearly visit at no cost for Medicare Advantage members, but it’s a health-planning session, not a physical exam. It includes a review of medical history, risk assessments, and basic measurements. It does not include blood work or any lab tests.9Humana. Medicare Annual Wellness Visit
If your doctor orders blood tests during the wellness visit, those tests are billed separately. Preventive blood tests ordered alongside the visit are generally covered at no cost. Diagnostic tests ordered to investigate a symptom or monitor a condition may carry a cost. Some Humana Medicare Advantage plans do offer an annual physical exam as an extra benefit, and unlike the wellness visit, a physical exam may include blood work. Your plan’s Evidence of Coverage will say whether this benefit is included.
At-Home Blood Testing Through Everlywell
Humana has partnered with Everlywell to send certain at-home lab test kits to eligible members at no cost. You receive a kit in the mail, collect the sample at home, and send it back in a prepaid envelope. Results are usually available within five to seven business days after review by a board-certified physician.10Everlywell. Humana Everlywell Welcome Kit
The available at-home tests include an HbA1c test to check blood glucose, a fecal immunochemical test for colorectal cancer screening, and a urine test for kidney function. Humana identifies members who are due for these screenings based on their health records and sends kits proactively.11Humana / Everlywell. Humana Everlywell At-Home Lab Testing If results come back out of range, Everlywell may schedule a virtual visit with a provider at no additional cost.
Which Labs Take Humana
Both Quest Diagnostics and Labcorp are in-network with Humana. Quest confirms it accepts Humana health plans and offers an online tool to verify your specific plan.12Quest Diagnostics. Quest Diagnostics Insurance and Health Plan Lookup Labcorp lists Humana among its agreements, though coverage can vary by geography and plan.13Labcorp. Labcorp Insurance Coverage
Verify your lab’s in-network status before the blood draw. Network agreements change, and some plans have narrower lab networks than others. The fastest check is through Humana’s online provider directory or the member services number on your card.
When Prior Authorization Comes Into Play
Routine and preventive blood tests generally don’t require prior authorization. Specialized lab work can. Humana’s provider site has a search tool where specific tests can be looked up by CPT code.14Humana. Prior Authorization Lists
Genetic testing is the main category where Humana applies detailed medical necessity criteria. For genetic tests used to diagnose inherited conditions, Humana typically requires pre- and post-test genetic counseling and evaluation by a relevant specialist. The insurer maintains clinical criteria for genetic testing related to conditions including ALS, fragile X syndrome, polycystic kidney disease, and hereditary angioedema. Some genetic tests, including expanded carrier screening panels and certain liquid biopsy tests for cancer, are classified as experimental and generally not covered.15Humana. Genetic Testing for Diagnosis of Inherited Conditions
For standard blood work ordered by your doctor, a physician’s order is the normal requirement. Direct-access testing, where you order your own lab work without a referral, is available at some facilities but is typically self-pay and cannot be billed to insurance.
If Humana Denies Your Blood Test
You can appeal. Medicare Advantage members have 65 days from the denial to file; Medicaid members have 60 days.16Humana. Humana Resolutions – Appeals and Grievances
Appeals can be submitted online through your Humana member account, by mail or fax using the Medical Service Appeal Request Form, or by calling Humana’s Medicare appeals line at 1-800-867-6601. If waiting on a standard appeal could jeopardize your health, you can request an expedited appeal, though this option isn’t available for services already received. Members who exhaust Humana’s internal process can continue through additional levels of Medicare review.17Medicare.gov. Medicare Claims and Appeals Free counseling through the State Health Insurance Assistance Program is available to help you work through it.