Does Medicare Cover Mammograms?

A mammogram is an X-ray image of your breasts. Doctors use this preventative service to look for early signs of breast cancer.

Mammograms play a key role in early breast cancer detection and help decrease breast cancer fatalities.

During a mammogram, your breasts are compressed between two plastic plates to spread out the breast tissue.

An X-ray then captures images of your breasts that are displayed on a computer screen. A doctor examines these images to screen for signs of cancer.

Having a mammogram is uncomfortable for many women. But the test only lasts a few moments, and the discomfort is over soon.

There is no ideal age to start screening for breast cancer.

Recommendations from many experts and medical organizations differ on when women should begin regular mammograms or how often the tests should be performed

However, there are a few general guidelines.

Many women with an average risk of breast cancer often start getting mammograms around age 40. According to the U.S. Centers for Disease Control and Prevention, 69% of women 40 or older had a mammogram in the last two years.

The American Cancer Society suggests that women with an average risk of cancer undergo annual mammogram screenings at age 45 until age 54, and then follow up with additional screenings once every two years.

Women with a high risk of breast cancer may want to begin screening mammograms at an earlier age.

If you have several high-risk factors, such as a family history of breast cancer or a history of precancerous breast lesions, your doctor may also recommend a magnetic resonance imaging, or MRI, in addition to your mammogram.

A regular screening mammogram is just one of many preventive services for women covered by Medicare.

Mammograms are covered under Medicare Part B. Medicare Advantage plans cover screening mammograms as well.

There are two primary types of mammograms Medicare will cover.

More specifically, there are conventional, digital and 3D mammograms. Medicare will cover these services so long as your doctor accepts Medicare.

You pay nothing for a yearly screening mammogram so long as your doctor accepts Medicare.

However, if your doctor recommends more frequent tests, such as a diagnostic mammogram, you will owe 20 percent of the Medicare-approved cost. The Part B deductible — $226 in 2023 — also applies.

A Medicare Supplement plan, or Medigap, can help you cover remaining out-of-pocket costs.

Your costs for a diagnostic mammogram may differ if you have a Medicare Advantage plan, or secondary insurance, such as Medicaid.