Does Medicare Cover Bone Density Tests?

Yes, Medicare Part B covers bone mass measurements (bone density tests) once every 24 months for qualified individuals. If you meet the criteria, you pay nothing for this test as long as your doctor or other qualified health care provider accepts assignment.

A bone density test helps to see if you're at risk for broken bones. It's a crucial preventive measure, especially as we age. Medicare considers this a preventive service, which means the Part B deductible and coinsurance do not apply if the conditions are met.

To qualify for this coverage, you must meet at least one of the following conditions:

• You're a woman whose doctor determines you're estrogen-deficient and at clinical risk for osteoporosis, based on your medical history and other findings.
• Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.
• You're taking prednisone or steroid-type drugs or are planning to begin this treatment.
• You've been diagnosed with primary hyperparathyroidism.
• You're being monitored to see if your osteoporosis drug therapy is working.

If your doctor recommends a bone density test more often than every 24 months, Medicare may cover it if it's deemed medically necessary. Always check with your provider to ensure they accept Medicare assignment so you can avoid unexpected bills.

When it comes to your health and your money, straight answers, no surprises is what you deserve. You've paid into the system your whole life, and you have the right to know exactly what's covered. The paper promises of Medicare can be confusing, but understanding your benefits is the first step to making sure you're not leaving money on the table.

It's important to remember that the Medicare system offers two paths, not two products. The real choice is Traditional Medicare (Part A and Part B) versus Medicare Advantage (Part C).

If you choose the Traditional Medicare path, your bone density test is covered under Part B as described above. If you have a Medicare Supplement (Medigap) plan, it works alongside your Traditional Medicare to help cover out-of-pocket costs for other services, though for this specific preventive test, Medicare covers 100% of the approved amount.

If you choose a Medicare Advantage plan, your plan must cover all of the services that Original Medicare covers, including bone density tests. However, you may need to see an in-network provider or get prior authorization, depending on your specific plan's rules.

Don't let confusion about Medicare coverage keep you from getting the care you need. We're on your side of the table, ready to walk you through every option.