Medicare Your Coverage Options

Preventive care: Bone density tests and osteoporosis

Written by Diane Archer

Preventive care is recommended to ensure you stay healthy. Bone density tests or bone mass measurements are a type of preventive care doctors often recommend to diagnose osteoporosis. Patients with osteoporosis have brittle bones and a high likelihood of breaking their bones.

According to the CDC, 16 percent of women over 50 and 4 percent of men over 50 have osteoporosis of the femur, neck or lumbar spine. The percentage grows significantly for people over 65—24.8 percent of women and 5.6 percent of men.

Medicare covers the full costs of a bone density test every two years if the doctor prescribes it because:

  1. You are estrogen-deficient at risk for osteoporosis based on medical history or other evidence;
  2. An X-ray shows vertebral abnormalities;
  3. You have been getting steroid treatments for at least three months;
  4. You are diagnosed with hyperparathyroidism;
  5. You are on a drug for osteoporosis.

For full Medicare coverage, you must see a doctor who takes assignment—accepts Medicare’s rate in full if you have traditional Medicare or an in-network provider if you are in a Medicare Advantage plan. However, if you take the test at the same time as you are getting examined for a range of issues, you will still bear the deductible and coinsurance costs of your doctor’s exam if they are applicable.

Medicare covers follow-up bone mass measurement or more frequent screenings for osteoporosis if your doctor prescribes them.

Provided you meet the qualifying criteria, Medicare also covers a range of other preventive care services, including an annual wellness visit, the flu shotweight counseling, nutrition counseling, smoking cessation, a cardiovascular screening and a diabetes screening.

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