Yes, Medicare covers mammograms for women 70 and older at no cost to you

Medicare Part B pays for screening mammograms once every 12 months for women age 40 and older, with no age limit. You pay nothing out of pocket — no copay, coinsurance, or deductible — as long as you go to a provider that accepts Medicare. This coverage continues whether you are 70, 80, or older.

The coverage applies to standard screening mammograms, which look for signs of breast cancer in women without symptoms. If your doctor orders a diagnostic mammogram because you have symptoms or a lump, Medicare also covers that, though the rules about your cost share may differ slightly depending on your specific plan.

Key Takeaways

  • Medicare Part B covers one screening mammogram per year for all women 40 and older, with no upper age limit.
  • You pay nothing when you use a Medicare-approved facility, even if you have not met your deductible.
  • Screening mammograms are covered; diagnostic mammograms (ordered because of symptoms) are also covered but may have different cost rules.
  • Your doctor's referral is not required, but you should confirm the facility accepts Medicare before your appointment.

How to find a Medicare-approved mammography facility

You can search for facilities that accept Medicare using the Medicare provider search tool on Medicare.gov. Enter your zip code and select "Mammography" as the service type. The results will show you hospitals, imaging centers, and clinics near you that are enrolled in Medicare.

Before you schedule, call the facility directly and tell them you have Medicare. Ask them to confirm they accept Medicare for screening mammograms and that you will have no out-of-pocket cost. Some facilities may ask for your Medicare card number to verify your coverage before your appointment.

What happens during a screening mammogram

A screening mammogram takes about 20 to 30 minutes. A technician will position your breast between two plates and take X-ray images from different angles. You may feel pressure or mild discomfort, but it is brief. The radiologist reviews the images and sends a report to your doctor within a few days.

If the mammogram shows something that needs a closer look, the facility will contact you and your doctor. They may recommend a diagnostic mammogram, an ultrasound, or another imaging test. These follow-up tests are also covered by Medicare if they are medically necessary.

Screening versus diagnostic mammograms and what Medicare covers

A screening mammogram is done when you have no symptoms and are checking for cancer as part of routine care. Medicare covers one per year with no cost to you. A diagnostic mammogram is done when you have symptoms (like a lump, pain, or nipple discharge) or when a screening mammogram found something unusual. Medicare covers diagnostic mammograms, but your cost may depend on whether your doctor ordered it as a medical necessity and your specific plan.

If you are unsure whether your mammogram is screening or diagnostic, ask the facility when you call to schedule. They can tell you which type your doctor ordered and what your cost will be.

Medicare Advantage plans and mammogram coverage

If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your plan must cover screening mammograms with no cost to you — this is a required benefit. However, the specific facilities you can use and any additional services (like 3D mammography) may vary by plan.

Contact your Medicare Advantage plan directly to find out which imaging centers are in-network and whether they cover additional types of mammography beyond standard screening. Some plans may cover 3D mammography (tomosynthesis) at no cost, while others may not.

When to talk to your doctor about mammogram screening

If you are 70 or older and have not had a mammogram in the past year, ask your doctor whether screening is right for you. While Medicare covers it, your doctor may recommend against routine screening if you have serious health conditions, a very limited life expectancy, or have already had breast cancer treatment.

Bring up any concerns you have — whether it is anxiety about the procedure, a family history of breast cancer, or questions about how often you should be screened. Your doctor can help you decide what makes sense for your situation and can place an order for a screening mammogram if you decide to proceed.

What to bring to your mammogram appointment

Bring your Medicare card and a photo ID. If you have a Medicare Advantage plan, bring that card instead. You may also want to bring any previous mammogram reports or imaging from other facilities, as the radiologist may want to compare them.

Wear a two-piece outfit so you can undress only the top. Avoid wearing deodorant, antiperspirant, powder, or lotion on the day of your appointment, as these can show up on the X-ray images and may cause confusion.

Frequently Asked Questions

Do I need a doctor's order to get a mammogram covered by Medicare?

No. You can schedule a screening mammogram directly at a Medicare-approved facility without a referral from your doctor. However, it is a good idea to tell your doctor you are having one so they can review the results with you.

What if my mammogram shows something abnormal?

The radiologist will send a report to your doctor and may contact you directly. Your doctor will discuss the findings and next steps, which might include a diagnostic mammogram, ultrasound, or biopsy. These follow-up tests are covered by Medicare if medically necessary.

Does Medicare cover 3D mammography?

Original Medicare covers standard 2D mammography with no cost to you. Coverage of 3D mammography (tomosynthesis) varies — some facilities include it as part of screening at no extra charge, while others may bill separately. Ask the facility before your appointment whether 3D imaging is available and what it will cost you.

Can I get a mammogram more than once a year?

Medicare covers one screening mammogram per 12 months. If your doctor orders additional mammograms because of symptoms or abnormal findings, those are covered as diagnostic mammograms. Your cost for diagnostic mammograms depends on your plan and whether you have met your deductible.

What if I have a Medigap plan — does that change my coverage?

No. Medigap plans work alongside Original Medicare and do not change your mammogram coverage. You still pay nothing for a screening mammogram. If you have a Medigap plan, it may cover some or all of any cost-sharing for diagnostic mammograms, depending on your specific policy.