Does Medicare cover mammograms?

Dear Kalani, 

Yes, Medicare covers both screening and diagnostic mammograms! If you’re not experiencing any symptoms and don’t have a history of breast cancer, Medicare covers mammogram screenings, also known as preventive mammograms, on the following schedule: 

• One baseline mammogram screening for women between the ages of 35 and 39 

• One annual mammogram screening for women 40 or older 

Your doctor may order a diagnostic mammogram if a screening mammogram shows an abnormal finding, they detect a lump during a physical exam, or if you are experiencing symptoms. Medicare will cover as many diagnostic mammograms as are medically necessary, on the schedule determined by your provider.  

Mammogram screenings are covered with no cost sharing if you have Original Medicare and see a provider who accepts assignment and or if you have a Medicare Advantage Plan and see a provider who is in-network. 

Diagnostic mammograms are covered as a regular Part B service. If you have Original Medicare, you’re responsible for 20% of the Medicare approved amount after you meet your Part B deductible. If you have a Medigap, Medicaid, or other secondary insurance, your costs may be lower. If you have a Medicare Advantage Plan, refer to your plan documents to learn about your cost-sharing for diagnostic mammogram services.  

To learn more about other preventative services Medicare covers, visit Medicare Interactive.  

-Marci