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Medicare pays for a Pap smear and pelvic examination every two years, or every year for women at high risk of cervical or vaginal cancer or of childbearing age with a recent abnormal result.
United States, Medicare National Coverage Determination 210.2, version 3, effective 19 June 2006. A screening Pap smear, with the related services and a pelvic examination including a clinical breast examination, is covered under Part B when ordered by a physician or authorised practitioner if the woman has not had the test in the preceding two years, or is a woman of childbearing age as defined in section 1861(nn) of the Social Security Act, or her practitioner recommends more frequent testing because she is at high risk. The NCD lists the high-risk factors as early onset of sexual activity (under 16), five or more lifetime partners, a history of sexually transmitted disease including HIV, fewer than three negative or any Pap smears in the previous seven years, and exposure to diethylstilbestrol (DES) in the womb. The screening pelvic examination, covered under section 4102 of the Balanced Budget Act of 1997, should include at least seven of eleven listed elements.
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