Is a 3D mammogram covered by Medicare?

A 3D mammogram is covered by Medicare once yearly as a screening tool for women over 40. Medicare will also cover diagnostic mammograms, but you will be responsible for your deductible and 20% coinsurance. If you have Medicare Advantage or a Medicare Supplement plan, your mammogram costs with Medicare may be lower or entirely covered.

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Chris Tepedino is a feature writer that has written extensively about home, life, and car insurance for numerous websites. He has a college degree in communication from the University of Tennessee and has experience reporting, researching investigative pieces, and crafting detailed, data-driven features. His works have been featured on CB Blog Nation, Flow Words, Healing Law, WIBW Kansas, and C...

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Laura Walker graduated college with a BS in Criminal Justice with a minor in Political Science. She married her husband and began working in the family insurance business in 2005. She became a licensed agent and wrote P&C business focusing on personal lines insurance for 10 years. Laura serviced existing business and wrote new business. She now uses her insurance background to help educate...

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UPDATED: Jan 21, 2022

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The Rundown

  • Medicare does cover 3D mammograms
  • One screening mammogram a year is covered by Medicare for women over 40
  • Diagnostic mammograms are only covered when medically necessary

Does Medicare cover 3D mammograms? The latest technology in mammograms, 3D mammograms can help detect early signs of breast cancer. Screening mammograms are covered by Medicare as part of preventative care. But does Medicare pay for 3D mammograms? Does Medicare cover mammograms if they are diagnostic?

Medicare coverage can be confusing, and if you’re not sure how Medicare mammogram coverage works, we can help. We’ll cover mammogram cost, how often you can get a mammogram with Medicare, and more right here.

Before reading more about Medicare coverage for mammograms, compare your Medicare coverage options. Enter your ZIP code above to compare costs for Medicare Advantage and Supplement plans right now.

Does Medicare pay for 3D mammograms?

Medicare covers regular preventative care, and for women, that includes regular mammograms. So does Medicare cover 3D mammograms, or is it only 2D mammograms that are covered?

The good news is that 3D mammograms, the latest technology, are covered by Medicare. If your doctor suggests that you have a 3D mammogram rather than a 2D one, you don’t have to worry about Medicare coverage.

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What Medicare coverage pays for a 3D mammogram?

Mammograms, as with all medical care, are covered under Medicare Part B. If you have a Medicare Advantage plan, you have the same coverage as all Medicare recipients who have both Parts A and B.

There is no out-of-pocket cost for a 3D screening mammogram if you have Medicare.

If you have a mammogram for a reason other than your regular screening, you may have to pay a deductible and coinsurance costs. You will also make sure you find a clinic that accepts Medicare.

How often does Medicare pay for mammograms?

Medicare will pay for one baseline mammogram for women between the ages of 35 and 39. From the age of 40 on, Medicare will pay for one screening mammogram each year.

A screening mammogram can be either a 2D or a 3D mammogram, depending on what your doctor recommends. A 3D mammogram may be better at detecting breast cancer in the early stages.

What’s the difference between a screening mammogram and a diagnostic mammogram?

A screening mammogram is done as an annual test to watch for early signs of a problem. It is done whether or not there are any other symptoms that might be a cause for concern. Screening mammograms may sometimes uncover something that needs a closer look.

If there are symptoms, or if something is found on a screening mammogram that requires diagnosis, your doctor may order a diagnostic mammogram.

Are mammograms covered by insurance if they are diagnostic? Yes, Medicare will pay for a diagnostic mammogram when it is medically necessary. However, unlike the screening mammogram, you will be responsible for coinsurance of 20%, and your Part B deductible applies.

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How much do you have to pay out-of-pocket for a 3D mammogram with Medicare?

As mentioned above, a screening mammogram is covered with no cost at all to you under Medicare Part B.

For a diagnostic mammogram, however, you will pay 20% of the cost after your Part B deductible is met. That deductible is $233 at the time of this writing. If you have a Medicare Supplement plan, you may have coverage for some or all of the deductuble and coinsurance.

This is the same whether you have a 2D or a 3D mammogram, although the 20% coinsurance may be a higher amount for a 3D mammogram, which may cost more overall.

Medicare Advantage will also pay for a screening mammogram at no cost. Medicare Advantage plans have varying levels of deductibles, coinsurance, and copays, so you will need to check with your plan to find out what a diagnostic mammogram will cost.

Medicare Coverage for 3D Mammograms: The Bottom Line

Medicare does pay for 3D mammograms, but the coverage depends on whether the mammogram is for screening or diagnostic purposes. Like 2D mammograms, screenings are covered in full, but diagnostic tests are subject to the Part B deductible and coinsurance.

To cover any out-of-pocket costs, you might want to consider either a Medicare Supplement plan or a Medicare Advantage plan. Enter your ZIP code below to compare options for Medicare mammogram coverage.

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