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Home Our Blog Medicare Covers Annual Mammograms

Medicare Covers Annual Mammograms

By Barry Zimmer on January 28th, 2016 in Care Planning

Did you know that more than 200,000 women are diagnosed with breast cancer every year? While there’s still no cure, there have been tremendous strides made in detection and treatment options. Mammograms are breast cancer screening tests that can detect a lump before you or your doctor can feel it. This helps to detect breast cancer early, when it’s most treatable.

breast cancer awareness
Source: Creative Commons

Medicare Part B, which is the medical insurance part of Medicare, covers annual screening mammograms and diagnostic mammograms when your doctor feels they’re medically necessary. Women over 40 and who also have Part B coverage are eligible, as are women with Part B coverage between the ages of 35 -39 also qualify for baseline mammograms.

Original Medicare Costs

You pay nothing for screening mammogram if your doctor or other health care provider accepts Medicare. With a diagnostic mammogram, you pay 20% of the Medicare-approved amount, and the Part B deductible applies after that.

To get specific numbers, you can speak with your doctor or other healthcare provider for exact costs. Keep in mind, it may depend on a number of factors, including any other insurance you may have, how much your doctor charges, whether your doctor accepts Medicare, the type of facility, and the location where you get your test is conducted.

My Doctor Says I Need More

Your doctor or other health care provider may advise you to get services more often than Medicare covers. He may also want you to have services that aren’t part of Medicare coverage. If this happens, you may have to pay some or all of the costs. Be sure to ask questions. Just as we, as estate planning lawyers, encourage our clients to ask questions about their wills, trusts, insurance, Medicare and Medicaid coverage, your doctors will encourage you to do the same so that you can better understand your options and whether or not you’re covered from a cost perspective.

The many pink ribbons we see throughout the month of October are created to invite conversation and to take the time to educate ourselves, whether we’re worried about an elderly family member or ourselves. To this end, the American Cancer Organization recently published a “7 Things to Know About Getting a Mammogram” infogram. We encourage everyone to explore this page.

Also, just as your estate planning lawyer encourages his clients to plan ahead, the same goes for our health. All women over 40 should have a mammogram every 12 months – and Medicare covers it at no cost if your doctor accepts assignment. If you’d like to know more about Medicare, Medicaid, Social Security and other insurance options as part of your estate planning efforts, we welcome you to contact The Zimmer Law Firm today at (513) 721-1513.

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