Medicare Part B covers bone density tests at no cost to you if you meet certain conditions

Medicare Part B pays for a bone density test (also called a DXA scan or DEXA scan) when your doctor orders it for one of the covered reasons. You pay nothing for the test itself — no copay, coinsurance, or deductible — as long as you use a provider in the Medicare network and your doctor's order meets Medicare's rules.

The catch is that Medicare only covers the test if you fall into specific groups. The test must be medically necessary, not routine screening for everyone. Your doctor has to document why they believe you need it, and that reason has to match what Medicare considers appropriate.

Key Takeaways

  • Medicare Part B covers bone density tests with no out-of-pocket cost when ordered by your doctor for a covered reason.
  • You must be a woman age 65 or older, or a man age 70 or older, or have specific risk factors that your doctor documents.
  • The test must be done at a Medicare-approved facility, and your doctor must order it — you cannot request it on your own.
  • Medicare covers one baseline test and follow-up tests at intervals your doctor determines, but not more frequently than every two years.

Who Medicare covers for bone density screening

Medicare covers bone density tests for women age 65 and older without any additional requirement. If you are a woman in this age group and your doctor orders the test, Medicare pays for it.

For men, Medicare covers the test starting at age 70. Men under 70 can still get coverage if they have risk factors — such as low testosterone, long-term corticosteroid use, or a personal history of fracture — and your doctor documents these in your medical record before ordering the test.

Younger women (under 65) and younger men (under 70) may also be covered if they have documented risk factors. These include osteoporosis in your family, rheumatoid arthritis, kidney or liver disease, or use of certain medications. Your doctor must note the specific reason in your chart.

How to get a bone density test through Medicare

Start by talking to your primary care doctor or a specialist who knows your medical history. Tell them you are concerned about bone health or that you have risk factors for bone loss. Your doctor will decide whether a bone density test makes sense for you and will place the order if they think it does.

Once your doctor orders the test, ask which facility they are sending you to. Make sure it is a Medicare-approved provider — most hospitals, imaging centers, and some outpatient clinics are approved, but it is worth confirming. When you arrive for the test, bring your Medicare card and any other insurance cards you carry.

The test itself takes about 10 to 30 minutes. You lie on a table while a machine scans your hip, spine, and sometimes your forearm. There is no radiation exposure worth worrying about — the dose is much lower than a standard X-ray. You do not need to undress or change into a gown.

What happens after your test results come back

Your doctor will receive the results and explain them to you at a follow-up visit or by phone. The results show your bone density compared to a healthy young adult (your T-score) and compared to others your age (your Z-score). A T-score of -1 or higher is considered normal. A score between -1 and -2.5 is low bone mass (sometimes called osteopenia). A score below -2.5 is osteoporosis.

If your results show low bone mass or osteoporosis, your doctor may recommend treatment, lifestyle changes, or a repeat test in the future. Medicare covers follow-up tests, but not more often than every two years unless your doctor has a specific medical reason to order one sooner.

What you pay out of pocket

If you have Original Medicare (Part A and Part B) and you meet the coverage rules, you pay nothing for the bone density test itself. Your Part B deductible does not explore, and there is no copay or coinsurance.

If you have a Medicare Advantage plan (Part C), your coverage may be different. Some Advantage plans cover bone density tests with no cost, while others may charge a copay or require you to meet a deductible first. Check your plan documents or call the plan's customer service number to find out what you owe.

If you have a Medigap (supplemental insurance) policy, it typically covers the coinsurance and copays that Original Medicare does not pay. Since Original Medicare covers bone density tests with no cost-sharing, your Medigap policy would not add anything in this case.

When Medicare does not cover bone density tests

Medicare does not cover routine screening bone density tests for people who do not meet the age or risk factor requirements. If you are a man under 70 with no documented risk factors, or a woman under 65 with no documented risk factors, Medicare will not pay for the test even if your doctor thinks it is a good idea.

Medicare also does not cover bone density tests ordered for reasons other than screening or diagnosis — for example, to monitor treatment response in someone already diagnosed with osteoporosis may have different coverage rules depending on the specific clinical situation. Ask your doctor whether the test they are ordering falls under Medicare's covered reasons.

If Medicare denies your claim, you have the right to appeal. Your provider can help you file an appeal, or you can contact Medicare directly at 1-800-MEDICARE.

Questions to ask your doctor before the test

Before your doctor orders a bone density test, ask why they think you need it. Ask whether the test will change your treatment or help guide decisions about your health. Ask which facility they will send you to and confirm it is Medicare-approved. Ask how long it will take to get results and when you will hear back from them.

If your doctor recommends treatment based on your results, ask what the treatment is, how long you will take it, and what side effects to watch for. Ask how often you will need follow-up tests and what you should do in the meantime to protect your bones.

Frequently Asked Questions

Can I get a bone density test if I am under 65 and female?

Yes, if you have documented risk factors such as family history of osteoporosis, rheumatoid arthritis, or long-term use of corticosteroids. Your doctor must note the reason in your medical record before ordering the test. Medicare will not cover the test without this documentation.

Do I need a referral to get a bone density test?

You do not need a formal referral, but your doctor does need to order the test. You cannot walk into an imaging center and request a bone density test on your own — Medicare will only pay if a doctor has placed the order for a covered reason.

How often can I have a bone density test?

Medicare covers bone density tests at intervals your doctor determines, but not more frequently than every two years. If your doctor believes you need testing sooner due to a change in your health or treatment, they can request an exception, but this is not automatic.

What if my Medicare Advantage plan denies the test?

Contact your plan to ask why it was denied. If you believe the denial is wrong, you can file a grievance with your plan. You can also call 1-800-MEDICARE to ask whether the test should be covered under Medicare rules, and Medicare can help you appeal the plan's decision.

Will a bone density test show if I have osteoporosis?

A bone density test measures your bone density and compares it to standards, which helps your doctor diagnose osteoporosis or low bone mass. However, the test alone does not diagnose the cause of bone loss — your doctor will use your medical history, risk factors, and test results together to understand your bone health.