Does Medicare Cover Bone Density Tests?

Last Updated : 09/10/20185 min read

You may have heard about bone density tests, but what is a bone density test and why would you need it? A bone density test can serve as a warning that you’re at risk for osteoporosis, or that you already have this disease.

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Osteoporosis is a disease that makes your bones weaker and thinner, according to the National Institutes of Health.

About one in four women aged 65 or higher have osteoporosis, while about one in 17 men have it, reported the Centers for Disease Control and Prevention (CDC) in 2017. If your doctor thinks you are at risk for this condition and recommends a bone density test, Medicare may pay for this test, as long as you meet certain requirements.

What is bone density?

The strength and mass of bones are referred to as bone density, according to Medical News Today. If bones have low density, they’re weaker and more likely to break. As we age, our bodies don’t replace bone cells as fast as we lose them to reabsorption.

What is a bone density test?

A bone density test is a painless scan that measures the amount of bone mineral density in certain bones in your body, according to the National Institutes of Health. Also known as a bone measurement test, the bone density test will tell your doctor if you have normal bone mineral density, low bone mineral density (also called osteopenia), or osteoporosis, a condition where weak bones make you vulnerable to fractures.

A bone density test can also:

  • Help predict your risk of fractures or broken bones
  • Indicate whether your bone density is improving, getting worse, or staying the same
  • Determine if your osteoporosis medication is working
  • Show whether a fracture was likely caused by osteoporosis

There are several types of bone density tests. One type uses a machine called a dual energy X-ray absorptiometry (DEXA) scanner, which uses low-dosage X-rays to diagnose osteoporosis.

There are also certain bone density tests available known as peripheral tests, which can measure your bone mass in the wrist, finger, lower arm, and heel. These bone density tests don’t diagnose osteoporosis, but can be helpful for determining whether further testing with a DEXA scan is necessary.

Who should get a bone density test?

The National Institutes of Health recommends that people with a higher risk for osteoporosis get bone density tests to screen for bone mineral loss; this includes all women 65 and older, and men 65 and over if they’re considered at high risk for fractures. Certain prescription drugs are known to contribute to bone loss, so you might want to ask your doctor about the medications you take.

In addition, you may want to talk to your doctor about getting the bone density test if you have any of the risk factors associated with osteoporosis, which include (but aren’t limited to):

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  • You have rheumatoid arthritis, chronic kidney disease, or an eating disorder.
  • You’re a woman who had an early menopause (either naturally or due to surgery).
  • You get very little exercise.
  • You’ve experienced height loss because of compression fractures in your spine.
  • You smoke.
  • You’re a frequent and heavy alcohol drinker.
  • You have a strong family history of osteoporosis.

Your doctor can recommend how often to get a bone density test based on your current status and risk factors.

Does Medicare cover bone density tests?

Medicare Part B may covers a bone density test, or bone mass measurement test, once every two years if you meet the eligibility requirements below:

  • You are an estrogen-deficient woman at risk for osteoporosis, based on your doctor’s examination and review of your medical history.
  • You have had an X-ray demonstrating possible osteoporosis, osteopenia, or vertebral fractures in your spine.
  • You are currently taking prednisone other steroid medications, or you’re about to begin steroid treatment.
  • You have been diagnosed with primary hyperparathyroidism.
  • You are currently on osteoporosis prescription drug therapy and your doctor wants to see if the treatment is effective.

Medicare may cover a bone density test more often than once every two years if your doctor believes it is medically necessary and you meet the above eligibility criteria. You may be eligible to receive the bone density test at no cost to you under Part B if your health-care provider accepts Medicare assignment. The bone mass measurement or bone density test must be ordered by your doctor or other qualified health-care provider to screen for your risk for fractures.

If you would like more information about Medicare coverage for osteoporosis and bone density tests, I am available to answer your questions. Want to learn about other coverage options you may have, including Medicare Advantage plans? Medicare Advantage plans are another way to get your Original Medicare benefits (except for hospice care, which Part A still provides) – and often include coverage for additional benefits like routine vision or dental, wellness programs, and more.

To request a phone call or email with information prepared just for you, click the corresponding link below. You can also view a list of plan options in your area by clicking the Compare Plans button.

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