Yes. Screening mammograms are covered as preventive care at no cost under the ACA on most private insurance plans. Medicare Part B covers one screening mammogram per year. Starting in 2026, expanded ACA rules also require coverage for diagnostic follow-up imaging without cost-sharing. The cost barrier is essentially gone. The only remaining barrier is remembering to schedule one.
Done in seconds. No sign-up required.
Before 2026, screening mammograms were already free, but women often got surprise bills when a screening turned into a diagnostic visit. If the radiologist saw something on the initial images and needed additional views on the spot, the visit could be recoded as "diagnostic" and subject to cost-sharing.
The expanded ACA requirements that took effect in 2026 close this gap. Group health plans must now cover the initial screening mammogram and any necessary additional imaging or pathology evaluations that result from it, all without cost-sharing.
This means you can walk into a screening mammogram without worrying about an unexpected bill if they need a closer look. The financial barrier is gone. Your only job is to actually show up.
The terminology affects what you pay.
Routine, scheduled exam for women with no symptoms. Covered at $0 under ACA and Medicare. This is what you're getting when you go in for your annual or biennial mammogram.
Ordered when something needs a closer look: a suspicious finding, a new lump, or follow-up from a prior screening. Coverage has historically varied, but 2026 ACA rules now extend no-cost coverage to diagnostic follow-ups from a screening.
Medicare Part B covers one screening mammogram every 12 months for women 40 and older. There's no copay and no deductible for the screening. You do need a doctor's order (referral) for the screening to be covered.
Diagnostic mammograms under Medicare are covered at 80% of the Medicare-approved amount after you meet the Part B deductible ($283 in 2026). Some Medicare Advantage plans may offer additional coverage. 3D mammograms (tomosynthesis) are covered under Medicare the same as standard mammograms.
Your insurance premiums fund preventive care coverage whether you use it or not. A screening mammogram is a benefit baked into your plan at no additional cost. Skipping it doesn't save you money. It just means you're paying for something you're not using.
Set a mammogram reminder and you'll get notified before your screening is due. The appointment is free. The only thing it costs is 30 minutes of your time. But skipping it can cost much more.
Under the ACA, screening mammograms are classified as preventive care and must be covered at no cost on most private insurance plans. No copay, no deductible, no coinsurance. This applies to women 40 and older getting screened at the recommended interval.
A screening mammogram is routine, for women with no symptoms. A diagnostic mammogram is ordered when something needs a closer look, like a suspicious finding on a screening or a new lump. Screening has been free under the ACA. Starting in 2026, diagnostic follow-up imaging is also covered without cost-sharing.
Yes. Medicare Part B covers one screening mammogram every 12 months for women 40 and older at no cost. Diagnostic mammograms are covered at 80% after the Part B deductible ($283 in 2026).
Not always. ACA preventive coverage follows USPSTF recommendations, which start at 40. If your doctor orders a mammogram before 40 due to high risk, coverage depends on your specific plan. Check with your insurer before scheduling.
The most common reason is that a screening mammogram was recoded as diagnostic during the visit, for example, if the radiologist found something that needed additional views on the spot. Starting in 2026, ACA rules require plans to cover this follow-up imaging without cost-sharing.
Most major insurance plans now cover 3D mammograms (breast tomosynthesis) the same way they cover standard 2D mammograms. Medicare has covered them since 2015. If you're unsure, call your insurer before scheduling.
Screening mammograms are free. Set a reminder so you actually use the benefit. No account needed.
Set My Mammogram ReminderLast modified: