Does Medicare Cover PET Scans?

Medicare typically does cover PET scans that are ordered by a doctor. Medicare Part B typically covers diagnostic non-laboratory tests or screenings, like PET scans, to learn how your organs and tissues are functioning.

Medicare Advantage (Part C) plans may also cover PET scans that are deemed medically necessary by your doctor, and they also include an annual out-of-pocket spending limit. This can potentially save you money in out-of-pocket Medicare costs for your PET scans.

Original Medicare does not include an out-of-pocket spending limit.

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When does Medicare pay for PET scans?

PET scans (positron emission tomography scans) may be ordered by your doctor in order to check for or diagnose a suspected disease or condition.

Some of the conditions a PET scan may be used to diagnose include:

  • Many types of cancer
  • Brain disorders, such as Alzheimer’s disease or tumors
  • Cardiac problems and heart disease

A PET scan may be able to reveal information that aren’t typically seen by a CT scan or an MRI.

Medicare Part B (medical insurance) typically covers your PET scan when ordered by your doctor.

What is the cost of a PET scan with Medicare?

If ordered by a doctor, Medicare Part B will typically cover 80% of the cost of a PET scan, up to three times per year. You'll be responsible for the remaining 20% after you meet your annual deductible for Medicare Part B, which is $198 per year in 2020.

Speak with your doctor directly for specific cost and coverage information.

Medicare Advantage plans may also cover PET scans

Every Medicare Advantage plan must cover everything that Original Medicare (Part A and Part B) covers.

If your PET Scan is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.

Most Medicare Advantage plans also cover prescription drugs, which are not typically covered by Original Medicare.

You can call to speak with a licensed insurance agent, who can help you compare Medicare Advantage plans that are available in your area.

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