Medicare covers mammograms at no cost to you as part of preventive care
Medicare Part B covers screening mammograms — the routine X-rays used to check for breast cancer in people without symptoms — at no charge. You pay nothing out of pocket, not even your Part B deductible. This coverage applies once every 12 months for women age 40 and older, and once every 24 months for women age 50 and older, depending on your risk factors and what your doctor recommends.
If your mammogram finds something that needs further investigation, a diagnostic mammogram to look more closely at that area is also covered by Medicare Part B. You will still pay nothing for the diagnostic mammogram itself, though you may have costs if additional tests like ultrasound or biopsy are needed.
The coverage applies whether you have Original Medicare (Part A and Part B) or a Medicare Advantage plan. If you have a Medicare Advantage plan, your coverage may differ slightly — some plans cover more frequent screening or additional services — so check your plan documents or call the plan directly to confirm what is included.
Key Takeaways
- Medicare Part B covers one screening mammogram every 12 months for women age 40 and older at no cost to you.
- Diagnostic mammograms — follow-up imaging when something abnormal is found — are also covered with no out-of-pocket cost.
- You must go to a Medicare-enrolled provider or facility for the mammogram to be covered; ask ahead of time whether the location accepts Medicare.
- If you have a Medicare Advantage plan, check your plan documents because coverage rules may differ from Original Medicare.
- Additional tests such as ultrasound, MRI, or biopsy may have separate costs even when the mammogram itself is free.
Where to get a covered mammogram
You can have your mammogram done at a hospital, imaging center, or doctor's office — as long as the facility is enrolled with Medicare. Before you schedule, call ahead and ask whether they accept Medicare and whether the specific mammogram you need (screening or diagnostic) is covered under your plan. This takes 30 seconds and prevents surprises later.
Your primary care doctor can refer you to a mammography facility, or you can search for one yourself using the Medicare provider search tool on Medicare.gov. If you have a Medicare Advantage plan, check whether the facility is in your plan's network; out-of-network facilities may cost you more or may not be covered at all.
What happens if the mammogram finds something abnormal
If the screening mammogram shows an area that needs closer look, your doctor will order a diagnostic mammogram. This is a more detailed X-ray focused on that specific spot. Medicare covers the diagnostic mammogram at no cost, just as it covers the screening mammogram.
If the diagnostic mammogram or other imaging suggests a biopsy is needed — a small tissue sample taken to check for cancer — that procedure is also covered by Medicare Part B. You will pay 20 percent of the Medicare-approved amount after you have met your Part B deductible for the year. The exact cost depends on where the biopsy is done and the specific procedure used.
Screening frequency and your age
Medicare covers one screening mammogram every 12 months for women age 40 and older. If you are age 50 or older and have no symptoms or high-risk factors, your doctor may recommend screening every 24 months instead — Medicare covers that schedule too. The decision about how often you should be screened is between you and your doctor based on your personal risk factors, family history, and medical history.
If you have a personal history of breast cancer, a family history of breast cancer, or genetic risk factors like a BRCA mutation, talk to your doctor about whether more frequent screening or additional imaging (such as MRI) is right for you. Medicare may cover supplemental screening in these cases, but the rules vary, so your doctor will need to document the medical reason.
Costs you might still have
The screening or diagnostic mammogram itself is free under Medicare Part B. However, if additional tests are ordered — such as breast ultrasound, MRI, or biopsy — those tests have their own costs. You will typically pay 20 percent of the Medicare-approved amount for these additional services after you meet your Part B deductible ($240 in 2024, though this amount changes yearly).
If you have a Medigap supplemental insurance policy, it may cover some or all of your 20 percent coinsurance for these additional tests. If you have a Medicare Advantage plan, your costs depend on your specific plan — some plans cover additional imaging at no cost, while others charge a copay or coinsurance. Check your plan documents or call your plan to understand your costs before the test.
What to bring and how to prepare
When you go for your mammogram, bring your Medicare card and any other insurance cards you have. Wear a two-piece outfit so you can remove your top easily. Avoid wearing deodorant, antiperspirant, powder, or lotion on your chest or underarms on the day of the mammogram, as these products can show up on the X-ray and may be mistaken for abnormalities.
Tell the technician if you have breast implants, are pregnant or think you might be, or have had recent breast surgery. Let them know if you have had a mammogram at another facility in the past year, because they may want to compare images. If you are still menstruating, schedule your mammogram for the week after your period starts, when breast tissue is usually less tender.
Medicare Advantage plans and mammogram coverage
If you are enrolled in a Medicare Advantage plan (Part C), your plan must cover at least the same screening mammograms that Original Medicare covers — one per year for women age 40 and older. Many Medicare Advantage plans cover additional screening, such as 3D mammography (tomosynthesis) or more frequent screening, at no extra cost.
Some plans also cover supplemental breast imaging like ultrasound or MRI for women with dense breast tissue or high risk. Check your plan's Summary of Benefits and Coverage document, which lists exactly what is covered and what you pay. If you cannot find the answer there, call your plan's member services number — it is on the back of your insurance card.
Frequently Asked Questions
Do I need a doctor's order to get a mammogram covered by Medicare?
No, you do not need a doctor's order for a screening mammogram. You can schedule one directly at any Medicare-enrolled facility. However, having your primary care doctor aware that you are getting screened is a good idea so your results can be added to your medical record.
What if I have not met my Part B deductible and need a diagnostic mammogram?
The screening mammogram itself is covered at no cost regardless of your deductible status. If additional tests like biopsy are ordered, you will pay toward your deductible first, then 20 percent coinsurance after the deductible is met. Ask the facility for an estimate before the procedure so you know what to expect.
Does Medicare cover 3D mammography or other advanced imaging?
Original Medicare covers 3D mammography (tomosynthesis) as a screening tool, though some regional variation exists in coverage rules. Many Medicare Advantage plans cover it as well. Call your provider or plan ahead of time to confirm whether 3D mammography is covered under your specific coverage.
What if my mammogram is done at an out-of-network facility?
If you have Original Medicare, the facility's network status does not matter — Medicare covers the mammogram at any Medicare-enrolled facility. If you have a Medicare Advantage plan, using an out-of-network facility may result in higher costs or no coverage at all. Always check your plan's network before scheduling.
Can I get a mammogram covered more than once per year?
Medicare covers one screening mammogram per 12 months for most women. If your doctor documents a medical reason for more frequent screening — such as a personal history of breast cancer or a high-risk genetic mutation — Medicare may cover additional mammograms. Your doctor will need to justify the frequency in your medical record.