Does Medicare Cover Mammograms? Complete 2026 Coverage Guide

Medicare Part B covers screening mammograms as a preventive service for women age 40 and older. You are eligible for one screening mammogram every 12 months at absolutely no cost to you: no deductible, no coinsurance, no copay. This applies as long as your provider accepts Medicare Assignment.

Medicare covers both 2D (standard digital) and 3D mammograms (digital breast tomosynthesis) as screening mammograms at the same $0 cost. Since 2015, Medicare has covered 3D mammograms without any additional out-of-pocket expense. 3D mammograms are particularly beneficial for women with dense breast tissue, as they can detect cancers that 2D mammograms may miss.

For women under 65 enrolled in Medicare due to disability, Part B also covers one baseline mammogram between ages 35 and 39. After age 40, the annual screening benefit applies regardless of how you qualified for Medicare.

There is no upper age limit for screening mammograms under Medicare. Women in their 70s, 80s, 90s, and beyond remain eligible for annual screening mammograms at $0 cost. About 6% of breast cancers are diagnosed in women aged 85 and older, making continued screening important.

When a screening mammogram detects an abnormality, or when you have symptoms such as a breast lump, nipple discharge, or breast pain, your doctor may order a diagnostic mammogram. Medicare Part B covers diagnostic mammograms at 80% of the Medicare-approved amount after you meet the annual Part B deductible ($283 in 2026).

Important: If your screening mammogram is reclassified as diagnostic during the same visit (because the radiologist finds something that needs closer examination), you will be responsible for 20% coinsurance even though you came in for a routine screening. This is a common surprise for beneficiaries. A Medigap plan or Medicare Advantage plan can eliminate this unexpected cost.

Medicare also covers additional breast imaging when medically necessary, including breast ultrasounds (often used for women with dense breast tissue or to evaluate a specific area), breast MRI (for high-risk patients or to evaluate the extent of known cancer), and follow-up imaging at intervals shorter than 12 months when monitoring a previously detected abnormality.

The average total cost of a diagnostic mammogram under Medicare is approximately $170 to $250. Your 20% share would be approximately $34 to $50 without supplemental coverage. With a Medigap Plan G or similar comprehensive supplement, your 20% coinsurance is covered, making your out-of-pocket cost $0.

Medicare Advantage plans must cover all Original Medicare benefits, including screening and diagnostic mammograms. Many Medicare Advantage plans go further by covering diagnostic mammograms at $0 cost (no coinsurance), eliminating the 20% cost-sharing that applies under Original Medicare.

When comparing Medicare Advantage plans for breast health coverage, look for plans that offer $0 copay for diagnostic mammograms and breast imaging, cover 3D mammograms at in-network imaging centers, include supplemental benefits like genetic counseling for high-risk patients, and have breast cancer centers of excellence in their network.

Some Medicare Advantage plans also cover supplemental breast cancer screening for high-risk women, such as annual breast MRI in addition to mammography. These enhanced benefits vary by plan and are typically available in plans with higher premiums or in areas with strong competition between insurers.

Approximately 40% of women have dense breast tissue, which makes mammograms less effective at detecting cancer. Dense tissue appears white on a mammogram, the same color as tumors, making cancers harder to identify. Women with dense breasts have a 4 to 6 times higher risk of breast cancer compared to women with fatty breast tissue.

As of 2024, the FDA requires all mammography facilities to notify patients about their breast density. If you are told you have dense breast tissue (categories C or D), talk to your doctor about additional screening options. Medicare Part B covers breast ultrasound and breast MRI when your doctor determines they are medically necessary based on your risk factors.

Medicare covers 3D mammograms at $0 cost for screening, and 3D technology is particularly beneficial for dense breast tissue. Studies show 3D mammograms detect 20-65% more invasive cancers in women with dense breasts compared to 2D mammograms alone. Always request 3D mammography if your facility offers it.

If your doctor recommends supplemental screening with breast ultrasound or MRI due to dense tissue, Medicare covers these services at 80% after the Part B deductible. Your 20% coinsurance is covered by Medigap plans. Some Medicare Advantage plans cover supplemental dense breast screening at $0.