Mammogram Insurance Coverage

covers:

One baseline mammogram if you’re a woman between ages 35-39.
Screening mammograms once every 12 months if you’re a woman age 40 or older.
Diagnostic mammograms more frequently than once a year, if Medically necessary .

Your costs in Original Medicare

Screening mammogram: You pay nothing for the screening test if your doctor or other qualified health care provider accepts Assignment .
Diagnostic mammogram: You pay 20% of the Medicare-approved amount , and the Part B Deductible [glossary] applies.

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

Other insurance you may have
How much your doctor charges
Whether your doctor accepts assignment
The type of facility
Where you get your test, item, or service

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

What it is

These screenings check for breast cancer.

Related resources

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Mammograms

Mammograms

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