Does Medicare Cover Mammograms?

Mammograms are one of the best tools for early detection of breast cancer, and being proactive about getting your annual mammogram after you turn 40 is critical for your overall health. While there are certain instances in which you may have to pay out-of-pocket, Medicare Part B and many Medicare Advantage plans both cover 100% of annual mammogram screening costs. Learn more about Medicare coverage for mammograms. . 

What part of Medicare covers mammograms?

Medicare Part B or a Medicare Advantage plan should cover 100% of yearly screening mammogram costs and 80 percent of necessary diagnostic mammogram costs. As a Medicare beneficiary, you will pay nothing for yearly mammograms. If your doctor determines it to be medically necessary, Medicare will also cover diagnostic mammograms more frequently than once a year. Generally, diagnostic mammograms are not considered a preventative service, so your Part B or Medicare Advantage plan coinsurance and deductible will most likely apply. 

Types of Mammograms Medicare Covers

There are three main types of mammograms to choose from when you are due for a mammogram:

• Conventional mammogram: A conventional mammogram takes 2-D black and white images of the breast. The doctor can view the images as they are taken to look for any deposits, lumps or other areas of concern. 
• Digital mammogram: Similar to a conventional mammogram, the digital mammogram takes 2-D black and white images. With a digital mammogram, the images are entered directly into a computer, allowing the doctor to zoom and enhance the images. 
• 3-D mammogram: A 3-D mammogram takes multiple images to produce a comprehensive 3-D view of the breast tissue. This type of mammogram has been shown to improve the diagnosis of cancer in dense breast tissues.

Medicare should cover the costs of both conventional and 3-D mammograms, however, not all providers offer 3-D mammograms. 

When is the right time for a mammogram?

Women over 40 are advised to get a mammogram annually. Women who are at increased risk for breast cancer should talk to their provider about starting their mammograms early and more often. Increased risk can include family history, genetic tendency, breast density and past breast cancer. 

How Long to Wait for a Mammogram After the Covid-19 Vaccine

Similar to other vaccines, the COVID-19 vaccine can cause temporarily enlarged lymph nodes, which can result in a “false positive” mammogram. For example, if the radiologist sees that your lymph nodes look large in your mammogram with no obvious explanation, they would consider it an abnormal finding. 

If possible, schedule your annual mammogram before you get your vaccine. If you’ve already received your vaccine, you’ll want to wait four to six weeks after your second dose to get your mammogram so that your lymph nodes can return to their normal size. 

Preparing for Your Mammogram

There’s not much you have to do to prepare for your mammogram once your appointment is scheduled. Since breasts can be tender the week before and during menstruation, consider scheduling your mammogram one or two weeks after your period starts. 

You may not want to wear deodorant, lotion or perfume the day of your appointment, as it can sometimes show up in the mammogram. You’ll also want to wear a two piece outfit so you can only have to remove your top and remain as comfortable as possible during the mammogram. 

Find a Medicare Plan That Covers Mammograms

Not only is it important to get your annual mammogram, but it’s also important that you get the most out of your Medicare coverage. When it comes to Medicare, we can help you save the time and hassle of navigating its complexities by shopping some of the most trusted insurance companies on your behalf, helping you find the coverage you need at the price you can afford.