Does Medicare Cover Bone Density Testing?

• by Christian Worstell
• November 9, 2023
• Reviewed by John Krahnert

Our bones lose density as we age, and we become more vulnerable to injuries like broken bones and diseases like osteoporosis. 

Fortunately for Medicare beneficiaries, bone density testing is covered by Medicare to increase the odds of early detection. In this guide, we outline how Medicare covers bone density testing and related care, and we detail some of the additional coverage options you may be able to consider to help pay for your tests as well as your other health care needs.

What happens during a bone density test?

Bone density testing does not require any special preparation on your part. You may be given a liquid to drink (or it may be administered through an IV) which will help produce better images of your bones for testing. 

The test is done by using a small amount of ionized radiation and an X-ray machine to determine the amount of calcium and other minerals in your bones and calculate their density. Bone density testing is also called dual energy X-ray absorptiometry, or DEXA.

Several factors can lower the density of your bones, including age, sex (women are more prone), tobacco and alcohol use, steroid use, malnutrition, rheumatoid arthritis, bone trauma and kidney disease. 

When does Medicare pay for bone density testing?

Bone mass measurements are covered by Medicare Part B (part of Original Medicare, which is administered by the federal government) and all Medicare Advantage plans (also called Medicare Part C plans, which are offered by private insurance companies).

Medicare beneficiaries are eligible for one bone density test every two years when one or more of the following conditions are met:

• You are a female who has been determined by a doctor to be estrogen deficient and at risk for osteoporosis based on your medical history and other findings.
  
  
• X-rays show a presence of possible osteoporosis, osteopenia or vertebral fractures.
  
  
• You are currently taking prednisone or a steroid-like drug or intend to begin taking them soon.
  
  
• You have primary hyperparathyroidism.
  
  
• You are undergoing osteoporosis drug therapy and are being monitored for progress. 

If you have any of the following conditions, you may qualify for more frequent bone density testing as needed:

• Rheumatoid arthritis
• Chronic kidney disease
• Overactive parathyroid gland or other hormonal imbalances
• Diabetes 
• You received an organ transplant

You will pay nothing for bone density testing when covered by Medicare Part B or a Medicare Advantage plan, as it is considered preventive care protected by the Affordable Care Act. That means there is no coinsurance or copayment, and no deductibles will apply.

• If you have Medicare Part B without a Medicare Advantage plan, the test must be performed by a doctor who accepts Medicare assignment.
  
  
• If you have a Medicare Advantage plan, it must be performed by a participating provider in the plan’s network, if your plan has network restrictions.

Though they’re offered by private insurance companies, Medicare Advantage plans are required by federal law to cover everything that Original Medicare covers. Many plans also offer benefits that Original Medicare doesn’t cover.

Learn more about the Medicare Advantage plans available near you and how they can help cover your bone health by calling to speak with a licensed insurance agent today.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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