Mammograms are very important for women, especially after 40. Mammograms are x-ray pictures of the breast that check for breast cancer in women have no symptoms or signs. This test can be expensive, so if you are Medicare-eligible you may wonder if Medicare covers the exam at all, and if it does how much you have to pay.
Yes. Not only are mammograms covered by Medicare, the yearly exam is FREE. However if you need a diagnostic mammogram, you will pay 20% of this cost. How much will that be for you? Well that is more complicated because each medical provider that offers diagnostic mammograms can charge a different price.
Medigap plans fill in the gaps of Original Medicare, therefore, yes, Medigap plans can cover the unforeseen cost of your diagnostic mammogram. Plans like “C” and “F” cover your Part B deductible, copays, and coinsurance, and you should not have any out of pocket costs after your monthly Medigap premium with these plans. Check out Medigap plans side by side to see which one cover the Part B coinsurance and copays.
Medicare Advantage does cover mammograms. With MA plans you still have the free preventive exam; however, since Medicare Advantage plans are not standardized, you’ll have to research how each company and plan cover diagnostic mammograms -remember MA plans must cover everything that Medicare does, but it can vary the way they charge for coverage.
To learn more about what Medicare covers call a Senior65 agent 800-930-7956.
By SANDRA FLEISCHMANN on May 10, 2017
If a patient had a diagnostic mammogram on 6/21/16 and is now scheduled for a screening mammogram on 5/11/17 will medicare cover the costs of this exam?
By Frieda Romine on March 31, 2017
Does Medicare cover mammograms after age 75? Thank you.
By anita defazio on January 24, 2017
I am due for my annual mammogram and am offered tomosynthesis? Is this covered too?
By Lenore levy on August 29, 2016
It is my understanding that while Medicare pays for a mammogram every year, I only need a doctor's script every OTHER year. The reason I was told is that I can only get a gynecological every other year. Is this correct or do I need a prescription for a mammogram every year even if Medicare will not pay for a yearly visit?
By Nancy Kowalski on August 10, 2016
I would like to know if my Medicare Plan F covers 3D Mammography? Thank you
By Ty on August 05, 2016
Does medicare cover 2D and/or 3D mammograms ? I also have Tricare For Life.
By mary jane costa on July 12, 2016
My mammogram last year was 8/31/15 and this year I am scheduled for 8/29/16. Is this test covered by Medicare within this time frame? Thank you
By SHARON on March 24, 2016
This question is from an imaging facility. A medicare covered patient has a physical finding on one breast. She is 6 days early for her annual bilaterl mammogram. Will a bilateral diagnostic be covered?
By Rita Brown on July 16, 2015
I just enrolled in Medigap C, will I have any out of pocket costs if I need a diagnostic mammogram? The reason I am concerned is two-fold, first, I have fixed income, and second, my sister had breast cancer. I think I'll need a diagnostic exam soon, and want to prepare for the costs.
By Dana Read on June 20, 2015
I like free. What other services are free with Medicare?
By Deanne S. on June 17, 2015
How many likely is it that I'd need a diagnostic mammogram?