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does Medicare cover 3-D mammograms

Does Medicare Cover 3-D Mammograms?

A 3-D mammogram takes multiple images of the breast from different angles. These images are then put together to provide a 3-D image of the breast tissue. 

3-D mammograms can be more effective than their 2-D counterparts. This is because they have been shown to improve the diagnosis of cancer in dense breast tissues. This test also goes by the name 3-D tomosynthesis mammography.  

For those over 65, a common question many have is, “Does Medicare cover 3-D Mammograms?” In this article, we answer that question in clear, plain English. You will also find the average costs of a 3-D mammogram and other helpful info. 

Does Medicare Cover 3-D Mammograms? 

The short answer is yes; Medicare will cover the cost of 3-D mammograms. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your 3-D mammogram. Below we look at what these are so you know what to expect. 

Original Medicare (Medicare Part A and Part B) provides coverage for 3-D mammograms. Medicare’s coverage for 3-D mammograms is the same as for other types of mammograms.  

Coverage for 3-D mammograms falls under Medicare Part B. Medicare Part B provides coverage for both screening and diagnostic mammograms.  

If you are a woman between the ages of 35 and 49, Medicare Part B will cover one mammogram test as a baseline test.  

If you are over 40 Medicare Part B provides coverage for one mammogram screening per year. Medicare Part B also provides coverage for one or more diagnostic mammograms – but only if it is necessary to diagnose breast cancer.  

Medicare Part B covers 100 percent of the costs of yearly screening mammogram test costs. On the other hand, Medicare Part B only covers 80 percent of a necessary diagnostic mammogram test cost. You will pay for the remaining 20 percent of the necessary diagnostic mammogram test.  

Medicare Advantage plans (Medicare Part C) also provide coverage for a 3-D mammogram test. They cover everything Original Medicare covers, as well as offer some additional benefits. However, exactly what it covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan. 

How Much Does A 3-D Mammogram Test Cost? 

The cost of a 3-D mammogram test can range from around $180 to $800. The average cost of a 3-D mammogram is around $550. As you might expect, 3-D mammograms are usually more expensive than traditional mammograms.  

The Benefits And Disadvantages Of 3-D Mammograms 

One of the well-known benefits of a 3-D mammogram is that they are more effective in detecting and diagnosing cancer in dense breast tissues than traditional mammogram tests.  

3-D mammograms simply produce a better and more detailed image. They are more comparable to the images you get in a CT scan.

Also, compared to traditional mammogram tests, they emit about the same amount of radiation (though, depending on the machine, 3-D may emit slightly more). However, the levels is both cases are considered very low dose.  

Though all of those may sound good, they are not perfect. There are some potential downsides to 3-D mammograms. Firstly, they are more expensive, so not everyone can afford one unless they have insurance. Another issue with 3-D mammograms is that they are not yet widespread in the US. So the technology is still unavailable to many people.  

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover skilled nursing?

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