Does Medicare Cover a Mammogram?

Medical research and development has made huge strides in the treatment of breast cancer over recent decades, but for many women, early detection remains a priority for the best outcomes. As well, mammograms continue to be some of the most effective diagnostic tests used to detect breast cancer early. No matter your age, all women are encouraged to work with their doctors to discuss breast cancer testing. This means that older women, even those who have gone through menopause, should ensure that breast cancer screening is a regular part of their health and wellness schedule.

Medicare Benefits Solutions

Oct 1, 2020

 4 minutes read

Does Medicare Cover Mammograms?
In the vast majority of cases, Medicare coverage does provide benefits for mammograms. This coverage includes one annual screening for women over 40 who receive Medicare benefits, but younger women may also be able to obtain one baseline screening from ages 35 to 39. You may also be covered for more frequent diagnostic mammograms if your doctor feels it is medically necessary. Remember that Medicare typically provides coverage for seniors, but it can also be used to insure younger individuals who have certain qualifying disabilities.

What Parts of Medicare Cover Mammograms?

Mammograms are usually covered by Medicare Part B when ordered by a physician as part of preventive care or as a medically necessary procedure. Part B will cover the annual screening, but it can also cover the cost of diagnostic screenings on a more regular basis if they are part of a treatment or monitoring plan. If you get a mammogram for diagnostic purposes, you’ll likely be responsible for 20% of the cost of the screening, and the Part B deductible applies.
Mammograms that are administered in a hospital during admittance may be covered by Medicare Part A as this is the inpatient benefit. What you need to know is that hospitals often bring in specialists from nearby medical offices to perform tests and administer treatment. If the hospital itself is not providing the mammogram, even if the mammogram is performed at the hospital, you may be billed separately by the attending physician.

Medicare Part D, the prescription drug benefit, would have no bearing on your mammogram coverage, but if may cover the cost of certain drugs used to treat breast cancer and related symptoms if the disease is found. This coverage is only available for medications sold in retail pharmacies. If you require the administration of medications in a hospital or clinical setting, the medications used would likely be covered by Medicare Part A or Medicare Part B, respectively.

Medicare Part D, the prescription drug benefit, would have no bearing on your mammogram coverage, but if may cover the cost of certain drugs used to treat breast cancer and related symptoms if the disease is found. This coverage is only available for medications sold in retail pharmacies. If you require the administration of medications in a hospital or clinical setting, the medications used would likely be covered by Medicare Part A or Medicare Part B, respectively.

Does Medicare Advantage Cover Mammograms?
Medicare Advantage plans often give you additional benefits on top of those offered through Original Medicare coverage, and these extra benefits may extend to mammograms. Some Medicare Advantage plans give plan members a wider network of providers to choose from, and you may also be able to take advantage of additional diagnostic screening procedures for a variety of medical conditions. Each plan and provider is different, however, so you will need to speak with a representative from your Medicare Advantage administration office for details about what is available to you.

Got questions?

Call a licensed sales agent at

866-576-2956 or TTY 711

Mon to Sun 5am - 8pm PT

Send us a message

We aim to reply within 24 hours.



    By submitting information on this website, you authorize Medicare Benefits Solutions, herein after referred to as “Medicare Benefits”, which is a brand operated by HealthCompare Insurance Services Inc., its agents, or affiliates to contact you (even if you’re on a state or national do not call registry) at the phone number or email address you provide to discuss your Medicare Advantage, Medicare Part D (Drug) and Medicare Supplement plan options. The company may contact you through the use of an automated dialer or a prerecorded message. You understand that you are not required to authorize such marketing calls as a condition of purchasing a policy or receiving service and that you can change your permission preferences at any time.

    Find a plan

    Get plan recommendations

    Compare your current Medicare plan to our recommendations – then choose the plan that gives you more of the things you want.