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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules state that thyroid function studies are used to delineate the presence or absence of hormonal 
abnormalities of the thyroid and pituitary glands. These abnormalities may be either primary or secondary and 
often but not always accompany clinically defined signs and symptoms indicative of thyroid dysfunction. 
Laboratory evaluation of thyroid function has become more scientifically defined. Tests can be done with 
increased specificity, thereby reducing the number of tests needed to diagnose and follow treatment of most 
thyroid disease. Measurements of serum sensitive thyroid-stimulating hormone (TSH) levels, complemented by 
determination of thyroid hormone levels [free thyroxine (fT-4) or total thyroxine (T4) with Triiodothyronine 
(T3) uptake] are used for diagnosis and follow-up of patients with thyroid disorders. 
Additional tests may be necessary to evaluate certain complex diagnostic problems or on hospitalized patients, 
where many circumstances can skew tests results. When a test for total thyroxine (total T4 or T4 
radioimmunoassay) or T3 uptake is performed, calculation of the free thyroxine index (FTI) is useful to correct 
for abnormal results for either total T4 or T3 uptake due to protein binding effects 
Indications 
Thyroid function tests are used to define hyper function, euthyroidism, or hypofunction of thyroid disease. 
Thyroid testing may be reasonable and necessary to: 
-Distinguish between primary and secondary hypothyroidism; 
-Confirm or rule out primary hypothyroidism; 
-Monitor thyroid hormone levels (for example, patients with goiter, thyroid nodules, or thyroid cancer); -Monitor drug therapy in patients with primary hypothyroidism; 
-Confirm or rule out primary hyperthyroidism; and 
-Monitor therapy in patients with hyperthyroidism. 
Thyroid function testing may be medically necessary in patients with disease or neoplasm of the thyroid and 
other endocrine glands. Thyroid function testing may also be medically necessary in patients with metabolic 
disorders; malnutrition; hyperlipidemia; certain types of anemia; psychosis and non-psychotic personality 
disorders; unexplained depression; ophthalmologic disorders; various cardiac arrhythmias; disorders of 
menstruation; skin conditions; myalgias; and a wide array of signs and symptoms, including alterations in 
consciousness; malaise; hypothermia; symptoms of the nervous and musculoskeletal system; skin and 
integumentary system; nutrition and metabolism; cardiovascular; and gastrointestinal system. 
It may be medically necessary to do follow-up thyroid testing in patients with a personal history of malignant 
neoplasm of the endocrine system and in patients on long-term thyroid drug therapy. 
Limitations 
Testing may be covered up to two times a year in clinically stable patients; more frequent testing may be 
reasonable and necessary for patients whose thyroid therapy has been altered or in whom symptoms or signs of 
hyperthyroidism or hypothyroidism are noted. 

You can find this rule at the Medicare National Coverage Determination (NCD) 190.22: Thyroid Testing. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com. 
 
The Plan contract says that the Plan covers items and services in accordance with Medicare rules.