Does Medicare cover ultrasound for dense breast tissue?

Medicare covers ultrasound for dense breast tissue when it is medically necessary. While Medicare covers mammograms as screening tools for breast cancer, ultrasound for dense breast tissue is only covered as a diagnostic tool. Ultrasound for dense breast tissue is covered under Medicare Part B and is subject to a deductible and coinsurance. Medicare Advantage plans may have different coverage for breast ultrasound.

Are you looking for free insurance quotes?

 Secured with SHA-256 Encryption

D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

Full Bio →

Written by

Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

Full Bio →

Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Jan 21, 2021

Advertiser Disclosure

It’s all about you. We want to help you make the right coverage choices.

Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.

Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.

Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.

The Highlights

  • Medicare covers ultrasound for dense breast tissue only if medically necessary
  • A mammogram is the only screening tool covered as a preventative test for breast cancer
  • Breast ultrasound is covered under Medicare Part B and is subject to a deductible and coinsurance of 20 percent

Does Medicare cover ultrasound for dense breast tissue? Medicare will cover breast ultrasound for diagnostic purposes when it is medically necessary. For breast cancer screening purposes, only mammograms are covered by Medicare in full. If your doctor determines that a breast ultrasound is required due to dense breast tissue or for any other medically necessary reason, you will pay the Part B deductible as well as 20 percent coinsurance. Medicare Supplement insurance can cover all or part of this out-of-pocket amount. 

You may also want to consider a Medicare Advantage health insurance plan, which often includes additional coverage not available with original Medicare.

If you would like to shop for a Medicare plan to cover breast ultrasound for dense breast tissue, enter your ZIP code now.

What coverage for breast ultrasound for dense breast tissue is included with Medicare?

If your doctor determines that further testing is required after a regularly scheduled screening mammogram or a diagnostic mammogram, you may be eligible for a breast ultrasound. This is usually done when dense breast tissue makes it difficult to view cancerous masses on standard mammography.

A screening mammogram is covered for all women on Medicare at regular intervals and is covered as preventative care. A breast ultrasound is usually treated not as preventative but as a diagnostic tool and is treated that way under your coverage.

Because Medicare Advantage plans are run by private health insurance companies, they can offer some slightly different coverage. Check with your plan provider to see what is covered.

Your one-stop online insurance guide. Get free quotes now!

 Secured with SHA-256 Encryption

What is the cost of breast ultrasound for dense breast tissue with Medicare?

Breast ultrasound is covered when necessary under Medicare Part B. That means it’s subject to the Part B deductible as well as coinsurance. After your deductible is met, Medicare will cover 80 percent of the cost. If you have Medicare Supplement insurance it will pay for all or part of the deductible and 20 percent health care coinsurance cost, depending on the plan you have.

Your cost with a Medicare Advantage plan will differ depending on your coverage details. Each Medicare Advantage plan has its own deductibles and coinsurance amounts. Check with your plan provider to find out how much it will cost you.

Does Medicare cover ultrasound for dense breast tissue? The Bottom Line

Medicare covers ultrasound for dense breast tissue when it is determined to be medically necessary. It will be covered under Medicare Part B and subject to a deductible and coinsurance. You can get some or all of those costs covered with a Medicare Supplement plan.

To compare your options for a Medicare plan that covers breast ultrasound for dense breast tissue, enter your ZIP code now.

Are you looking for free insurance quotes?

Your one-stop online insurance guide. Get free quotes now!

 Secured with SHA-256 Encryption