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Does Medicare Cover Mammograms?

12/15/2022
  • Medicare with Melissa

Mammograms are an important part of preventative health care for women, as they help to detect breast cancer early. So, it’s important to know if Medicare covers mammograms and how to go about getting one.

When it comes to Medicare coverage for mammograms, the answer is yes. Medicare Part B covers the cost of screening mammograms once every 12 months for women who are 40 years of age or older. Medicare Part B also covers 80% of the cost of diagnostic mammograms.

What is a screening mammogram?

Screening mammograms are used to detect breast cancer in women who have no symptoms or signs of the disease. This type of mammogram can help to find breast cancer early when it’s easier to treat.

What is a diagnostic mammogram?

Diagnostic mammograms are used to take a closer look at a suspicious area that was detected during a screening mammogram. They’re also used to diagnose breast cancer in women who have signs or symptoms of the disease.

During a diagnostic mammogram, multiple X-ray images of the breast are taken from different angles. The images are then examined by a radiologist for any suspicious areas. The results from a diagnostic mammogram will help your doctor determine whether further action is necessary, such as a biopsy or other imaging tests.

Is a mammogram painful?

No, a mammogram is not painful. It may be uncomfortable because the breast must be compressed between two plates, but it should not be painful.

How long does a mammogram take?

A mammogram typically takes about 30 minutes.

How often should you get a mammogram?

The American Cancer Society recommends women aged 45 to 54 get a mammogram every year, and women aged 55 and older get a mammogram every two years. Women at higher risk should talk to their doctor about how often they should get a mammogram.

How much does a mammogram cost?

The cost of a mammogram can vary depending on the type of mammogram needed, the facility providing the mammogram, and the patient’s insurance coverage. Out-of-pocket costs also vary state to state, so it’s important to speak with an insurance agent to determine your exact costs.

How to prepare for a mammogram?

1. Wear a two-piece outfit so you can easily remove the top half.

2. Avoid using antiperspirant, deodorant, body powder, or lotion on the day of the mammogram. These products can interfere with the results.

3. Make sure to inform the technologist of any recent injuries, surgeries, or other medical conditions that may affect the mammogram.

4. Describe any breast symptoms or problems to the technologist, such as pain, lumps, swelling, or discharge.

5. Let the technologist know if you have breast implants.

6. Let your doctor know if you are pregnant or think you may be pregnant.

7. Plan and schedule your mammogram at a time of the month when your breasts are least tender or swollen.

8. Relax and try to remain still during the test. Taking deep breaths can help.

What to expect from a mammogram?

A mammogram is a low-dose X-ray of the breasts used to check for breast cancer. During the mammogram, you will be asked to stand in front of the X-ray machine and place your breasts on a flat surface. The technician will then press a plastic plate against each breast to flatten and hold it in place. This may be a little uncomfortable but should not cause any pain. The images will then be taken and sent to a radiologist for review. The whole process usually takes about 20-30 minutes.

How long does it take to get mammogram results?

The amount of time it takes to get mammogram results can vary depending on the facility and the type of exam performed. In general, results can be available within 1 to 3 weeks.

Are mammograms covered 100% by Medicare?

Medicare covers 100% of the cost of screening mammograms. Medicare only covers 80% of the cost of diagnostic mammograms, meaning you are responsible for the remaining 20% coinsurance. However, you can use Medigap or Medicare Advantage plans to help offset the 20% out-of-pocket cost of the diagnostic mammogram.

Does Medicare pay for 3D mammograms?

No, Medicare does not pay for 3D mammograms. However, some private insurers may cover the cost of a 3D mammogram.

How often does Medicare cover mammograms?

Medicare covers one screening mammogram every 12 months for women with a average risk of breast cancer. Medicare also covers a diagnostic mammogram more often if medically necessary.

Does Medicare stop paying for mammograms at a certain age?

No, Medicare does not stop paying for mammograms at a certain age. Medicare Part B covers one mammogram every 12 months for women over the age of 40.

Conclusion

Mammograms are an important tool in the detection and prevention of breast cancer. When it comes to getting a mammogram, it’s important to talk to your doctor about what type of mammogram you need and what’s covered by Medicare. Your doctor will be able to tell you if you need a screening mammogram or a diagnostic mammogram and can refer you to a facility that accepts Medicare.

Medicare covers one screening mammogram every 12 months for women 40 years of age or older. It also covers 80% of the cost of diagnostic mammograms. It’s important to talk to your doctor about how often you should get a mammogram and to discuss any concerns or questions you have about the procedure.

Medigap and Medicare Advantage plans are insurance plans offered by private providers that can help to offset any additional costs associated with mammograms including the 20% coinsurance expense. Be sure to speak with an insurance agent to see if one of these plans is right for you.

For more information about Medigap or Medicare Advantage plans, please call 866-MEDIGAP (866-633-4427) to speak with a licensed agent. We can help you find the best coverage and plan to meet your individual needs and budget.

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.

-Melissa

Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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