Medicare pays for many preventive services in order to aid you in staying healthy. Preventive services can find problems early and can help keep you from getting some diseases or illnesses. These services include exams, lab tests, and screenings. One of these services is the bone mass measurement or bone density test.

What is a Bone Mass Measurement?

A bone mass measurement or bone density test is the best way to determine your bone health. Bone Mass Measurements can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to treatment. Osteoporosis is a disease in which your bones become weak. The results of a bone mass measurement will assist you with osteoporosis prevention.

What Does the Bone Density Test Do?

The most common bone mineral density test is called a dual-energy x-ray absorptiometry or DXA test. It is similar to having an x-ray. The test measures bone density in your spine, hip and/or wrist, the most common sites of fractures due to osteoporosis. Your bone density test gives you a ‘score’ that is compared to standards. Although no bone density test is 100% accurate, it is the single most important predictor of whether a person will have a fracture in the future.

Are Bone Mass Measurements Covered by Medicare?

Medicare Part B covers bone mass measurements to determine whether or not you are at risk for a fracture (broken bone). This test is covered once every 24 months, or more often if your doctor deems it necessary.

In general, the lower your bone density score, the higher your risk is for a fracture. Bone mass measurement test results will help you choose the best method of osteoporosis prevention. A bone density test should always be a part of a complete medical workup supervised by a doctor.

Do I Qualify for a Bone Density Test?

All people with Medicare who are at risk for osteoporosis (as determined by a doctor) qualify for a test. Your risk for osteoporosis increases if you:

• Are age 50 or older
• Are a woman
• Have a family history of broken bones
• Have a personal history of broken bones
• Are White or Asian
• Are small-boned
• Have low body weight (less than about 127 pounds)
• Smoke or drink a lot
• Have a low-calcium diet

What Do I Pay?

You pay 20% of the Medicare-approved amount. You must pay the Part B yearly deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. If a doctor, health care provider or supplier does not accept assignment, the amount you pay may be higher. If you receive your Medicare coverage through a Medicare Advantage Health Plan, you may owe little to nothing depending on the plan you are signed up with and your benefits with the plan.

If your doctor recommends that you have this test more often than Medicare covers them, you may have to pay for these additional services. Ask your health care provider to find out how often you need the bone mass measurement.