Mammograms and Medicare

Due to the frequent nature of breast cancer occurring in women over 30 it is a good idea to get mammograms on a regular basis.  The ugly disease or condition of breast cancer will not go away if you ignore it so you need to screen regularly to see if you can prevent it.  Medicare does allow for screenings for breast cancer in the form of mammograms, but only according to the 12 month rule.

Due to the frequency of the subject being brought up there is much debate and frustration about the 12 month rule.  In spite of this it is actually quite easy to follow if you just think about it.  Basically, every individual covered by Medicare gets one mammogram every 12 months if they are over the age of 40, otherwise the limit is one between the age of 35 and 39.

Your mammogram will be denied if you do not follow the basic principles of the 12 month rule by Medicare.  This 12 month period will begin the month after the month in which you had your last mammogram.  So, if you are keeping score at home, you can’t have another mammogram performed until the same month the next year or later.

One Response to Mammograms and Medicare

  • what about women who are most at risk, like if their previous scan shows a mass, or what if they are most at risk if their mom, sisters, or grandmothers has breast cancer? will they be able to get more than one scan?

    Hoffman Estates, IL

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