Women need to schedule to get mammograms regularly. Regular checks can help detect breast cancer earlier on, which means one can get treatment successfully. Medicare is a federal government-sponsored healthcare service for individuals aged 65 years and older. It offers a range of women health services, including mammograms.
If you have Medicare Advantage plans or Medicare part B, they can cover your diagnostic and screening mammogram says Medicare specialist from clearmatchmedicare.com. Your medical situation and plan will determine the level of coverage you get and if you will have other out of pocket expenses.
What is a Mammogram?
Mammography or mammogram is a form of X-ray that is used in diagnosing or detecting breast cancer. This is why women must get one regularly. Generally, they are scheduled for women aged 50 years and above yearly to help catch the disease in the early stages.
One has to undress from the waist up during this test to allow the machine to access the breasts fully. The mammography machine has two specialized camera plates where each breast will be placed and be compressed for imaging.
Mammograms do not take more than 20 minutes. Typically, the compressions last for a few seconds, but you may notice some pain, discomfort, or pressure.
What Medicare Covers
Note that only specific parts of Medicare will cover a mammogram. It will be best to check if you have mammogram coverage once you attain the recommended age of getting one. Medicare will cover you for:
- A single or more diagnostic mammogram to diagnose a medical condition like breast cancer, if necessary
- A single screening mammogram, if you are a woman aged 40 plus, after every twelve months
- A single mammogram, if you are a woman aged between 35 to 49, as a baseline test
Below are the parts of Medicare and what they cover.
Medicare Part A
The hospital insurance or Medicare part A only covers the treatments or services required when you are admitted as an inpatient in a hospital. Typically, a mammogram cost will not be included in Medicare part A.
Medicare Part B
This covers outpatient treatment and diagnostic services. Medicare part B will cover your diagnostic mammogram and screening mammogram. Therefore, it is necessary for anyone who wants to have this vital test covered since paying for it out of pocket is not viable.
Medicare Part C
Medicare Advantage plans or Medicare part C is a private insurance plan. You can use it to replace Medicare part A and Medicare part B. This plan offers part B and part A coverage, meaning it will cover similar mammogram costs that part B covers. Some plans may offer medical transportation coverage that may be useful if you require help to get to your mammogram appointment
Medicare Part D
This plan covers prescription drugs, and it does not cover any mammogram costs. However, it may be useful in covering the medication costs should you need breast cancer medication.
Essentially, this plan supplements Medicare part B and Medicare part A. Getting it can significantly reduce your out of pocket expenses. If you already have the two primary Medicare plans and need help with additional mammogram costs like coinsurance and deductibles, consider getting Medigap.
The Cost of a Mammogram
While Medicare can help cover your mammograms costs likely, you will still incur some out of pocket costs. It will cover 80% of the necessary mammogram diagnostic costs and 100% of the yearly mammogram screenings.
Generally, the additional out-of-pocket costs you may have to pay include deductibles and premiums owed and the 20% coinsurance cost. The additional charges can be off-putting for some individuals who may decide not to get the service altogether. However, women need to get a mammogram. Therefore, if you need a mammogram screening, find out if you qualify for the low-cost or free breast cancer screening.
The Types of Mammogram Covered by Medicare
There are three primary types of mammograms that one can get. This include:
This mammogram takes several pictures during the test to give the full breast tissue’s 3-D view. This type of mammogram is shown to enhance cancer diagnosis in dense breast tissues.
It takes a 2-D black and white image of the breast. These images are directly entered into the computer, which allows your doctor to enhance, zoom, and inspect these images with accuracy.
This mammogram takes 2-D black and white film images of the breast. The doctor will view these images during the test as they are and look for any deposits, lumps, and additional areas of concern.
Medicare coverage will cover the costs of a conventional mammogram and a 3-D mammogram. It is worth mentioning that all providers do not offer 3-D mammograms. Please consult with your doctor about what mammogram will be right for you and find out what tests are available.
How Regularly You Can Get Mammograms on Medicare
You can get a mammogram screening covered on Medicare part B once every twelve months. Medicare part C also covers mammogram screenings, but you must confirm that a doctor is included in the plan. As long as your healthcare provider accepts Medicare, you will not be charged for a mammogram screening.
It is essential to get a Medicare plan since it can help cover your mammogram costs. Find out what plan will best suit your needs and reduce the additional costs you may incur. Ensure that you get regular breast screening since it can make a significant difference should you have breast cancer. If you have a higher risk of getting breast cancer, ensure that you start getting the screenings from 40 years. Consult with your doctor and find out what would be the appropriate time to schedule a mammogram.