What Medicare covers
| Mammogram | Who and how often | What you pay |
|---|---|---|
| Baseline | Once, for women 35 to 39 | Nothing, if the provider accepts assignment |
| Screening | Every 12 months, women 40 and older | Nothing, if the provider accepts assignment |
| Diagnostic | When medically necessary, even more than once a year | 20% after the Part B deductible ($283 in 2026) |
Medicare counts the 12 months from your last screening, so a screening booked too early may not be covered. Ask the imaging center to check the date of your last one.
When a mammogram can cost you
- The screening turns up something. Follow-up images, a diagnostic mammogram, ultrasound or biopsy are billed with the usual Part B cost sharing.
- The provider doesn't accept assignment. You may owe more than the Medicare-approved amount.
- A hospital outpatient setting. Diagnostic tests there can add a hospital copayment.
A Medigap policy pays part or all of the Part B coinsurance for diagnostic tests.
If you live in Oregon
Hospitals and imaging centers across Oregon do mammograms; in rural counties the nearest center may be in the next town over, so book your yearly screening early. If you have both Medicare and the Oregon Health Plan, OHA says OHP can help pay Medicare deductibles and coinsurance, and people in the QMB program pay no Part B cost sharing. See Medicare and OHP together.
Medicare Advantage plans must cover screening mammograms at no cost in network. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. You can request a call from a licensed insurance agent to compare plans from the companies they work with.
Related questions
Does Medicare cover bone density tests in Oregon?
Osteoporosis screening.
Does Medicare cover a colonoscopy in Oregon?
Colorectal screening.
Does Medicare cover annual physicals in Oregon?
Your yearly checklist.
Sources
More questions in this guide
- Does Medicare cover acupuncture in Oregon?
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- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
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- Does Medicare cover a colonoscopy in Oregon?
- Does Medicare cover CPAP machines in Oregon?
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- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
What's the difference between a screening and a diagnostic mammogram?
A screening mammogram checks for breast cancer when you have no signs or symptoms. A diagnostic mammogram looks into a lump, symptom or a finding from a screening. Medicare covers screening at no cost with assignment, and diagnostic mammograms with the usual Part B deductible and coinsurance.
Can I get a diagnostic mammogram more than once a year?
Yes. Medicare.gov says diagnostic mammograms are covered when medically necessary, which can be more often than once a year.
Do I need a doctor's order for a screening mammogram?
Many imaging centers schedule screening mammograms without an order, but some ask for one. Check with the center, and confirm it accepts Medicare assignment.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
