Your Medicare Coverage

Is my test, item, or service covered?


How often is it covered?

Medicare Part B (Medical Insurance) covers a:

  • Screening mammogram once every 12 months (11 full months must have passed since the last screening)
  • Diagnostic mammogram when medically necessary

Who's eligible?

  • Women with Part B 40 or older are covered
  • Women with Part B between 35-39 can get one baseline mammogram

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 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.

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