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Medicare covers mammograms for women age 35 and over. However, some restrictions apply.
Medicare may cover some mammograms completely, though some diagnostic mammograms may require you to pay out-of-pocket costs such as deductibles or coinsurance.
Medicare Supplement Insurance (Medigap) can help cover diagnostic mammogram Medicare costs.
Medicare covers annual mammograms for women age 40 and older.Mammograms help detect early breast cancer in women who show no symptoms of the disease.
Every year, breast cancer accounts for about 30% of all new cancer cases in U.S. women. According to Breastcancer.org, one in eight American women (13%) will develop invasive breast cancer in her lifetime.1 The earlier breast cancer is detected, the more treatable it is.
Mammograms can detect changes in the breast up to two years before a physician can feel them, making them an invaluable tool for the treatment of breast cancer.
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Generally, Medicare Part B will fully cover annual mammograms for women age 40 and older, and will cover one baseline mammogram for women age 35-39.
Medicare will also cover diagnostic mammograms that are considered medically necessary by a doctor.
Your annual screening mammogram is completely covered by Medicare if your doctor or provider accepts Medicare assignment.
If you require a diagnostic mammogram, you typically must meet your Part B deductible and pay 20% of the Medicare-approved amount for your mammogram.
Medicare Part B deductible
Your Part B deductible is the amount you must pay out of pocket before Medicare will pay its share. In 2024, the Part B deductible is $240 per year.
Medicare Part B coinsurance
After your deductible is met, you'll typically be responsible for 20% of the Medicare-approved amount for your mammogram.
Keep in mind that these costs are in addition to your Medicare Part B monthly premium. In 2024, the standard Part B premium is $174.70 per month.
It is also important to find out whether or not your doctor accepts Medicare assignment.
Doctors and health care providers who accept assignment agree to accept the Medicare-approved amount as full payment for covered services.
If your doctor does not accept assignment for covered services, he or she can charge you more than the Medicare-approved amount.
Learn more about Medicare coverage of common procedures
Medicare Supplement Insurance helps cover some of Original Medicare's out-of-pocket costs, including the deductibles, copayments and coinsurance you might face if you get a diagnostic mammogram.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
Learn more about Medicare coverage of common procedures
Or call 1-800-995-4219 to speak with a licensed insurance agent.
1 Breast Cancer Facts & Statistics. (Updated November 8, 2023) BreastCancer.org. Retrieved from www.breastcancer.org/symptoms/understand_bc/statistics.
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareSupplement.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
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