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A mammogram is an x-ray of the breast done to detect signs of breast cancer. Mammograms are recommended yearly starting around age 40. Women with a higher risk of breast cancer should be screened before age 40.

If you don’t have any symptoms or a history of breast cancer, Medicare Part B covers:

  • One baseline mammogram for women ages 35-39
  • One annual screening mammogram for women age 40 and older

For these preventative screenings, Medicare pays 100 percent. This means if you qualify, you won’t have to pay a copay, coinsurance, or anything toward your deductible.

Your doctor may order a diagnostic mammogram if you have a lump or if you exhibit symptoms of breast cancer. Medicare will cover 80 percent of the cost of diagnostic mammograms, leaving you to pick up 20 percent of the cost after you’ve met your Part B deductible.

You may have as many diagnostic mammograms as your doctor deems necessary. Medicare will cover diagnostic mammograms for both men and women.

Costs

For baseline and screening mammograms, Medicare pays 100 percent of your costs. For diagnostic mammograms, Medicare pays 80 percent, while you pay 20 percent of the costs after meeting your Part B deductible.

What to Know

Try to schedule a mammogram at a time when your breasts will not be tender, such as the week after your period. Don’t wear a dress, since you will need to undress on the top for your mammogram. Do not wear deodorant, perfume, lotion, or powder, since those can be picked up on the x-ray and interfere with the image. Do not wear earrings or a necklace to the mammogram.

Medicare By State

Medicare is regulated by the federal government. However, private insurance companies are allowed to offer various parts of Medicare, and these plans can differ from state to state.

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