Medicare covers X-rays, but you will still need to pay deductibles and copayments.
Medicare Part A covers inpatient X-rays.
Medicare Part B covers outpatient X-rays.
Medicare doesn’t typically cover dental X-rays or X-rays recommended by your chiropractor.
X-rays are a common diagnostic test. This imaging test lets your doctor see what’s happening in your body without performing any invasive testing. Doctors order hundreds of X-rays every year; these tests are quick, easy and safe. Best of all, they’re usually covered by Medicare.
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If your doctor orders an X-ray, it’s probably covered. Medicare covers all medically necessary X-rays. This includes X-rays to assess any injuries or help your doctor diagnose an illness.
Medicare Part A
Medicare Part A covers X-rays if you’re an inpatient in the hospital. Part A coverage only applies if you’re admitted to the hospital and you receive inpatient care. Sometimes you can receive care at a hospital without being an inpatient. For example, if you’re spending a night in hospital for observation, you may still be an outpatient.
Ask your doctor about your patient status to find out if Part A coverage applies.
Medicare Part B
Medicare Part B covers all medically necessary diagnostic X-rays. If your doctor orders an X-ray and you’re an outpatient, Medicare Part B will cover the test. Part B covers X-rays at healthcare facilities like:
- Outpatient clinics
- Testing centers
- Urgent care centers offering radiology services
- Emergency rooms
- Hospitals offering outpatient care
- Specialist offices
Medicare Part C
Medicare Advantage plans offer comprehensive coverage that includes inpatient and outpatient X-rays. When your doctor orders an X-ray, Part C has you covered. As long as you get a medically necessary X-ray from an in-network provider, your healthcare coverage applies.
Medicare covers X-rays, but how much you pay for X-rays depends on your plan.
Original Medicare Part B pays 80% of the Medicare-approved cost of X-rays. Deductibles and coinsurance still apply. This means you’ll need to meet your yearly deductible before Medicare coverage kicks in. After that, you’ll have a bill for 20% of the X-ray cost.
Medicare Advantage plans set their own coinsurance and copayments, and most plans have low deductibles. Check with your plan provider to find out how much an X-ray will cost. Medicare Advantage plans have a cap on yearly out-of-pocket spending, so you might pay less for your X-ray.
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An X-ray is a prevalent imaging test that can generate a picture of bones and tissues in your body. This image helps your doctor understand what’s happening in your body. One of the most common X-rays is a mammogram that doctors use to look for signs of breast cancer. Doctors can order X-rays to:
- Examine an area where they suspect cancer cells or tumor growth.
- Determine if you have an enlarged heart or other cardiovascular complications.
- Look for the cause of pain or discomfort.
- Check for bone fractures and breaks, or monitor osteoporosis.
- Examine your gastrointestinal tract to find the source of digestive issues.
X-rays are standard procedures performed by a radiologist. You’ll stand, sit or lie down between the camera and an X-ray detector. Once you’re in position, all you have to do is stay still for several seconds while the technician takes a few images. The technician will move a large camera arm around you, capturing several images from different angles.
A contrast dye may be required before the test, depending on the body part X-rayed. The dye can improve the quality of the X-ray so the doctor can get a better picture of what’s going on. You can swallow the dye in liquid, or the radiologist may inject it into your body.
The radiologist typically won’t give you the results from your test, so you may need to go to your doctor for a follow-up visit. Results are usually available within 24 hours. Your doctor will review the results and make a diagnosis. Sometimes they may order follow-up tests like blood tests or an MRI to confirm what they’re seeing.
Do X-rays have side effects?
X-rays are generally safe, but they produce a naturally occurring kind of electromagnetic radiation to take the images. In rare cases, this radiation might cause some mild side effects.
X-rays can sometimes be painful. For example, if you have a broken or fractured bone in your arm, you might have some additional pain during the X-ray. You’ll need to hold your arm in the right position to get a clear picture. You may need to bend or straighten your arm in a way that hurts.
In very rare cases, you might have a reaction to the contrast dye. You might experience itching, hives, lightheadedness or nausea. These effects will go away once the dye is out of your system.
Medicare covers chest X-rays if they’re ordered by your doctor. Chest X-rays are usually considered medically necessary, so Part B coverage applies. Chest X-rays let doctors take a closer look at your heart, lungs, spinal column and ribs. Your doctor may order a chest X-ray if you have chest pain, a persistent cough or shortness of breath. Chest X-rays can diagnose heart failure, pneumonia, broken ribs or cancer.
Because your lungs are in the picture, you’ll need to hold your breath during a chest X-ray to prevent the image from looking blurry. X-rays are safe if you have a pacemaker or a metal implant.
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Medicare does not cover tests ordered by a chiropractor. If your chiropractor suggests you get X-rayed, you’ll pay out of pocket. You can take these concerns to your doctor, and explain that your chiropractor is worried about your spinal alignment. If your doctor orders a spinal X-ray, Medicare coverage applies.
Original Medicare doesn’t cover dental care. However, if you’re in the hospital and need a jaw X-ray following an injury, Medicare Part A will cover the X-ray.
Some Medicare Advantage plans cover dental X-rays. These comprehensive plans offer the same benefits as Original Medicare, and may also offer additional coverage like dental, vision and hearing services. Check with your plan provider to find out what’s covered in your plan.
To learn more about Medicare Advantage plans that include dental X-rays, call a GoHealth licensed insurance agent at 1-855-792-0088 (TTY: 711). We’ll answer all your Medicare questions and help you get the X-ray coverage you need.
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Most X-rays are covered under Medicare Part B. You’ll need to meet your yearly deductible before coverage applies. After that, you pay a 20% coinsurance.
If you have an X-ray while you’re an inpatient in a hospital, Medicare Part A typically will pay for 100% of the X-ray after you’ve paid your benefit period deductible.
Medicare Advantage plans may offer more coverage. Each Medicare Advantage plan has different copayment policies and out-of-pocket costs.
Medicare Supplemental plans, or Medigap, can pay for X-rays. This plan helps fill in some cost “gaps” in your Original Medicare coverage. When you get an X-ray, Medicare pays for 80%. Then Medigap may pay the remaining 20% and eliminate this costly gap in coverage.
Medicare covers most medically necessary tests as long as your doctor orders them. You’ll get Medicare coverage for:
- CT scans
- PET scans
- MRI scans