Should You Pay Out of Pocket for Extra Health Screenings?

Whole-body MRIs. Cancer tumor-marker blood tests. You’ve seen ads and testimonials from influencers about them on social media. You’re curious, but your health insurance doesn’t cover these tests, and some are pricey. Should you splurge? Will it provide valuable health information? What do doctors think?

In recent years, many people have paid out of pocket for health screenings that aren’t routinely offered by primary care providers. Companies marketing directly to consumers offer one-time tests and paid subscriptions. But the information some of these tests provide may be less valuable than the marketing suggests.

“They can be very compelling because they tap into an understandable desire for certainty and control over one’s health,” said Rigved Tadwalkar, MD, a cardiologist at the Pacific Heart Institute, a Cedars-Sinai affiliate.

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Many patients don’t ask their doctors what they think about the tests before they order them. They do, however, bring their test results to their doctors for interpretation.

“Everyone wants a quick answer and a solution, and they order those tests,” said Taras Benzar, MD, a hematologist/oncologist at The Angeles Clinic and Research Institute, an affiliate of Cedars-Sinai Cancer. “Once they order the test, there’s no follow-up from those companies. The patients have their healthcare in their own hands.”

If health insurance doesn’t cover a specific screening test, it doesn’t mean the test isn’t worthwhile or necessary for a specific individual. Doctors order tests for patients based on evidence and the patient’s unique circumstances. Sometimes, recommended testing may come with an out-of-pocket price tag.

But it’s wise to be wary of direct-to-consumer screening tests that haven’t been ordered based on evidence. People should have meaningful conversations with their doctor before committing to a costly medical test that may not provide helpful information.

Screening is highly personal. We have to consider what we’re looking for, how the result would change care and what tradeoffs come with finding something unexpected.

When Out-of-Pocket Health Screenings May Be Beneficial

Some health insurance companies don’t cover newer screening tests that doctors order, such as coronary artery calcium CT scans, also known as calcium score tests. When doctors recommend a calcium score test and insurance doesn’t cover it, they may direct patients to a facility that performs the test inexpensively. Patients who can’t afford the out-of-pocket fee aren’t tested.

Sometimes, health insurance companies deny coverage for a screening test that doesn’t seem relevant, like a colonoscopy for a 35-year-old when screening is recommended at 45 or older. A 35-year-old whose parent was diagnosed with colorectal cancer in their early 40s may choose to pay for a colonoscopy, hoping to be reimbursed by health insurance later.

“A patient may be having symptoms, with a strong family history of malignancies, but there are insurance delays due to paperwork or prior authorizations,” Benzar said. “They could opt to pay out of pocket if they need something urgently.”

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When Out-of-Pocket Health Screenings May Be Problematic

Doctors recommend screening tests—including breast, colorectal and prostate cancer screenings—based on evidence-based medicine, ordering them when patients have symptoms and a family history of a specific condition or fall within a recommended group for the screenings. Doctors don’t recommend testing for unlikely conditions.

“A healthy 30-year-old generally doesn’t need a full-body MRI or executive health screen,” Tadwalkar said. “More testing isn’t automatically better. The value comes from choosing tests that answer a meaningful clinical question and can actually change care.”

Some doctors worry that patients who get desired test results may neglect their health.

“If everything looks good, it can cause false reassurance,” Benzar said. “Patients could abandon proven, age-specific screening for breast cancer, prostate cancer or inherited malignancies because a blood test or imaging tests showed that everything is normal.”

Common Health Screenings With Out-of-Pocket Fees

Several blood and imaging tests are available for purchase. We asked three physicians to weigh in on screening tests that people commonly seek out.

✅        Doctor Recommended for Select Patients

Calcium Score Test

Many primary care providers and cardiologists recommend this test, which measures the amount of hardened, calcified plaque in the arteries leading to the heart. Doctors use the information to predict heart attack risk.

“Coverage remains inconsistent, which is frustrating because in the appropriately selected patient, a calcium score can meaningfully change preventive decision-making,” Tadwalkar said.

🚫        Not Doctor-Recommended

Whole-Body MRI or CT scan

More than 100,000 Americans have gotten full-body scans to assess their overall health. The procedure costs thousands of dollars. Research hasn’t shown that there’s a benefit to looking for cancer or other health conditions this way, without targeting a specific area.

“You’re always going to find something. I’ve yet to see one that says ‘perfection,’ because there is no perfection,” said Christopher Fitzgerald, MD, an internal medicine specialist at Cedars-Sinai Primary Care in Beverly Hills. “A lot of these MRI companies are membership-based, so you do it every two years.”

If a whole-body scan finds anything abnormal, people spend more money following up on findings, possibly getting a biopsy, which usually turns out to be nothing.

“I can’t, in good faith, recommend whole-body MRI for routine screening,” Tadwalkar said. “Incidental findings are common, and they can create significant uncertainty and anxiety without a clear benefit to the patient.”

✅        Doctor Recommended

Lipoprotein(a)

This blood test is a more advanced cholesterol test. It looks for lipoprotein(a), a type of “bad” cholesterol that people inherit. People with high levels are at increased risk of heart disease, even if their standard cholesterol screening looks good.

Previously, the American College of Cardiology (ACC) and the American Heart Association (AHA) supported lipoprotein(a) testing selectively. Recently, the 2026 guideline from the ACC/AHA Joint Committee on Clinical Practice Guidelines recommends that all adults should be screened with the lipoprotein(a) test at least once.

“This is about as close to a slam dunk as screening tests get,” Tadwalkar said. “It’s relatively inexpensive and easy to obtain, and because levels are generally stable over time, repeat testing is usually unnecessary.”

🚫        Not Doctor Recommended

Multicancer Screening Tests

Two types of direct-to-consumer blood tests are designed to predict a person’s cancer risk. A simple blood panel for tumor markers can look for signs of inherited gene mutations that increase cancer risk. A multicancer early-detection test looks for signs of microscopic cancer cells that may be in the bloodstream.

“These tests are not standardized, and they can be affected by any underlying inflammatory conditions,” Benzar said. “You don’t necessarily have cancer. You could be having an inflammatory process, an infection. You’d have to speak with your physician and try to obtain the additional workup, which causes a lot of anxiety.”

The lack of standardization often produces confusing results. The quest for clarification sometimes leads to additional CT and MRI scans—which are generally not covered by insurance when prompted by direct-to-consumer tests—and unnecessary biopsies.

*️⃣        Sometimes Doctor Recommended

DEXA Bone-Density Scan

A bone-density scan is routinely offered to women 65 and older to check their osteoporosis risk. Some doctors recommend a baseline DEXA scan for women when they reach menopause. Health insurance may not cover the test, but it may be useful.

“If someone knows their bones are thin when they reach menopause, that might get them to the gym,” Fitzgerald said. “To me, that’s a successful test. And it’s affordable.”

🚫        Not Doctor Recommended

Broad-Scale Screening Tests

Some companies use a blood sample to test for dozens of common and uncommon health problems, instead of targeting age-appropriate conditions. These tests often come with a monthly or annual subscription, but they typically make the same discoveries as the routine lab work that doctors order.

“It has not really panned out in large-scale studies to do that screening on every single person, with every physical,” Fitzgerald said. “But an influencer will tell them, ‘This will find things even sooner,’ and so people seek out those tests.”

*️⃣        Sometimes Doctor Recommended

Advanced Cardiovascular Screening

Some companies bundle vascular screening tests such as carotid ultrasound, abdominal aortic aneurysm ultrasound and peripheral artery testing. Recommendations differ by test and by a person’s age and risk factors.Some are appropriate for select people, while others are not recommended for routine screening.

“They aren’t routine screening tests in all populations, but some people want data,” Fitzgerald said. “Sometimes it will get them to stop smoking or it will get them to the gym, because they have objective evidence their lifestyle is leading to disease. In those cases, I think that’s a win.”

🚫        Not Doctor Recommended for the General Population

APOE4 Test for Alzheimer’s Disease

Doctors use this test appropriately when patients have signs of dementia. It’s a blood test that looks for genetic variants that are linked to Alzheimer’s disease, but it isn’t a diagnosis. Offering the APOE4 test to a person without cognitive symptoms, alone or as part of a panel, is not recommended.

“I talk people out of that test,” Fitzgerald said. “Can you imagine getting a blood test that says you could have Alzheimer’s? We don’t have a confirmatory test, it may not actually translate to disease, and we don’t have a known intervention. But people are doing it.”

How to Decide If You Should Pay Out-of-Pocket for Screening Tests

Before doing any screening tests, consider your reaction to health information or test results. Some tests have unclear answers or require unnecessary follow-up testing.

“How good are you with the gray zone?” Fitzgerald said. “If you have high healthcare-related anxiety, this could wreak havoc on you.”

The best way to gauge the reliability of specific screening tests is by talking to your doctor.

“Screening is highly personal,” Tadwalkar said. “We have to consider what we’re looking for, how the result would change care and what tradeoffs come with finding something unexpected. That’s where a trusted physician relationship really matters.”