Good news, it's unlikely you'll be out of pocket for blood tests, regardless of whether or not you've got health insurance.
Blood tests can be covered by Medicare, as long as your doctor is registered with Medicare and is the one who ordered the test.
If you have to undergo a pathology test while in hospital then it's likely your health insurance policy will cover you.
If your doctor has ordered you to undergo a pathology or blood test, you might be wondering how much this procedure is going to cost. You might also be confused as to whether some or all of the cost will be covered by Medicare or your private health insurance fund. Let’s take a look at how blood tests work and whether you will need to pay for them out of your own pocket.
Does private health insurance cover blood tests?
Private health insurance can sometimes cover the cost of blood tests depending on whether you receive treatment as an inpatient or outpatient. If you undergo a pathology test while admitted to hospital as an inpatient, hospital cover from your private health fund should cover this expense. If you undergo a pathology or blood test as an outpatient, such as through your GP, you probably won’t be covered. Outpatient blood tests are typically covered by Medicare (unless you’re an overseas visitor, in which case your private health insurance may provide some cover).
Keep in mind that even if cover for the cost of a blood test is provided by Medicare or private health insurance, there may be some out-of-pocket costs. This occurs if the pathology costs are greater than the Medicare rebate and the amount covered by your private health fund.
Finder survey: How many people worry that Medicare will not be enough?
Response
Yes
51.59%
No
26.04%
Not sure
22.37%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
Is blood work covered by Medicare?
The Australian Government provides funding for a wide range of pathology tests through the Medicare Benefits Schedule (MBS). However, you will only be eligible for a rebate on a blood test listed on the MBS if the following conditions are met:
The pathology test must be requested by your treating practitioner (the practitioner must be registered with Medicare)
There must be a medical reason for the blood test
Your blood sample must be sent to a pathology laboratory that is approved by Medicare
The pathology test has been supervised and has undergone quality assurance in line with Medicare accreditation rules
As an example, if a blood test is requested for insurance purposes rather than for a medical reason, it will not be eligible for a rebate.
It's also worth pointing out that there are sometimes limits on the number of times you can receive a rebate for the same blood test in a 12-month period. More details about any limits that apply can be found in the MBS.
Why compare health insurance with Finder?
We don't ask for your phone or email to see prices.
With 1 click, you can open your results to nearly every fund in Australia.
You pay the same price as going direct – we charge no fees.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
You'll pay the same price as going direct - we don't
charge fees
We don't ask for your phone number to see prices
Hang tight - we're fetching policies just for you!
Comparing quotes from 40+ funds...
Common questions about blood and pathology tests
Below are some of the common questions we're asked about blood work and other pathology tests.
A blood test can be used to assess your overall health and help your doctor diagnose or observe and check the progress of a wide range of conditions. When you undergo a blood test, a small amount of blood is taken from a vein in your arm and then sent off to a pathology service to be tested and analysed.
Blood tests generally produce accurate results but can sometimes produce 'false positives' or 'false negatives'. Blood tests can be used for an incredibly diverse range of purposes, from checking that your major organs are working correctly to assessing how well your blood is clotting, checking the effectiveness of medications you are taking and testing for diseases such as cancer and diabetes.
The cost of blood tests varies depending on the type of test. However, under Australian legislation, pathology testing providers cannot issue invoices for pathology services until all testing has been completed. With this in mind, you won't know for sure exactly how much a blood test will cost before your blood is collected, but the pathology service can provide you with an estimate of your out-of-pocket expenses. You can also ask your doctor for information about how the pathology tests will be billed.
The good news is that Medicare can help cover the cost of blood tests in many situations.
In some cases you may be required to take certain steps to prepare for a blood test, such as fasting for a specific period of time. Blood tests can be conducted in hospital or at a pathology collection centre. Once you've provided your doctor's referral and confirmed your personal details, the collector will usually place a tourniquet around your arm and insert a needle into your vein.
A small amount of blood will be taken and then collected in one or multiple tubes before being sent to a pathology service for analysis. You'll be asked to apply pressure to the needle site for a short period and you should minimise the use of that arm for the next 24 hours. Some patients can suffer from dizziness or even faint after blood is taken. If you think you're at risk of this, be sure to keep your fluids up and stay seated for a while after your blood has been collected.
Once your blood sample has been tested and analysed, the results will be sent to your doctor. The time it takes for your results to be ready will vary depending on the type of test you have done.
If your doctor has recommended that you get a Pap test or if you've simply been putting it off for a while and decided that it's time to have one, you might be wondering if you'll have any out-of-pocket expenses. The good news is that Medicare provides cover for most of the cost of a Pap test. If your medical practice bulk bills, you probably won't have to pay any out-of-pocket costs.
However, some medical professionals will charge a fee for performing the Pap test or for the laboratory testing process. As a result, you may have to pay the portion of the total cost that exceeds the Medicare rebate. The MBS lists the fee for a Pap test as $19.45 so a 75% benefit equals $14.60 and an 85% benefit is $16.55.
Tim Falk is a writer for Finder, writing across a diverse range of topics. Over the course of his 15-year writing career, Tim has reported on everything from travel and personal finance to pets and TV soap operas. When he’s not staring at his computer, you can usually find him exploring the great outdoors. See full bio
Prenatal care in Australia is covered by Medicare, meaning it’s mostly free through the public system. You can choose to go private, which comes with a lot of benefits – but there are out-of-pocket expenses to watch out for.
This guide looks at the reasons people switch, and what it means for your waiting periods. You can also compare new options with over 30 Australian health funds.
What are the most common complaints Australian consumers have about private health funds and private health insurance? Find out in this comprehensive guide.
Are people with disabilities supported by government funding alone or does private health insurance also have a part to play? This guide looks at the contribution both sectors make to caring for the disabled.
How likely would you be to recommend Finder to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Very UnlikelyExtremely Likely
Required
Thank you for your feedback.
Our goal is to create the best possible product, and your thoughts, ideas and suggestions play a major role in helping us identify opportunities to improve.
Important information about this website
finder.com.au is one of Australia's leading comparison websites. We are committed to our readers and stands by our editorial principles
We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
Some product issuers may provide products or offer services through multiple brands, associated companies or different labeling arrangements. This can make it difficult for consumers to compare alternatives or identify the companies behind the products. However, we aim to provide information to enable consumers to understand these issues.
We make money by featuring products on our site. Compensation received from the providers featured on our site can influence which products we write about as well as where and how products appear on our page, but the order or placement of these products does not influence our assessment or opinions of them, nor is it an endorsement or recommendation for them.
Products marked as 'Top Pick', 'Promoted' or 'Advertisement' are prominently displayed either as a result of a commercial advertising arrangement or to highlight a particular product, provider or feature. Finder may receive remuneration from the Provider if you click on the related link, purchase or enquire about the product. Finder's decision to show a 'promoted' product is neither a recommendation that the product is appropriate for you nor an indication that the product is the best in its category. We encourage you to use the tools and information we provide to compare your options.
Where our site links to particular products or displays 'Go to site' buttons, we may receive a commission, referral fee or payment when you click on those buttons or apply for a product. You can learn more about how we make money.
When products are grouped in a table or list, the order in which they are initially sorted may be influenced by a range of factors including price, fees and discounts; commercial partnerships; product features; and brand popularity. We provide tools so you can sort and filter these lists to highlight features that matter to you.
Please read our website terms of use and privacy policy for more information about our services and our approach to privacy.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
