Does Medicare Cover Pet Scans?

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PET scans help detect cancer and other diseases, including those in the heart and brain. In most cases, Medicare does cover PET scans, as long as they are considered medically necessary. Here, we’ll look at the expenses you may have to pay out of pocket, as well as the basics of PET scans.

Understanding PET Scans

Positron emission tomography scans (PET scans) allow doctors to check for a number of diseases in your body. These include:

  • Cancer
  • Heart problems
  • Disorders of the brain
  • Central nervous system problems

With PET scans, patients are given a special dye, injected in their veins. Bodily organs absorb this dye. Then, when highlighted under a PET scan, these images reveal characteristics such as blood flow and oxygen use.

These important measures help physicians diagnose illnesses by providing a clear window into complex diseases, including: 

  • Coronary artery disease
  • Memory disorders
  • Brain tumors

Additionally, PET scans help your physician judge whether you have a cancer that has spread through your body and can even reveal how chemotherapy is affecting a tumor.

Costs

PET scans can cost in the thousands of dollars without insurance. If you have Medicare Part B, your PET scan will likely be covered. Medicare considers PET scans to be “diagnostic non-laboratory tests,” a category that also includes CT scans and MRIs.

However, even with Medicare coverage, your PET scan likely will not be free. Medicare Part B still requires beneficiaries to pay 20 percent of all Medicare-approved costs of these tests, and your Part B deductible must be paid before Medicare will cover its share. In 2017, the standard Part B deductible is $183 per year. 

Medicare Supplement Insurance (Medigap) helps cover some of your Medicare out-of-pocket costs. To be eligible for Medigap, you must be enrolled in Medicare Part A and Part B. You cannot enroll in a Medigap plan if you have Medicare Advantage (Medicare Part C).

To learn which Medigap plans are available in your area, speak with a licensed agent at 888-264-0148.

What Else Does Medicare Cover?

Original Medicare covers a wide range of services and procedures. For a comprehensive list of covered health care services, read through our guide What Does Original Medicare Cover?

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Sources:

Healthline.com: http://www.healthline.com/health/pet-scan#uses2

Choosingwisely.org: http://www.choosingwisely.org/patient-resources/pet-scans-after-cancer-treatment/

Medicare.gov: https://www.medicare.gov/coverage/diagnostic-tests.html

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