Finding the best path to affordable mammograms can feel overwhelming. While one patient might discover her insurance company charged $75 for what she thought would be a free screening, another woman with similar income could get the exact same mammogram at no cost by choosing a different route. The difference? Understanding the system.

Let’s simplify this maze so you can make the choice that works best for your situation and wallet.

Understanding Your Insurance Coverage

Most private insurance plans cover screening mammograms at no cost for women 40 and older, thanks to the Affordable Care Act. Medicare Part B covers annual screening mammograms at no cost for women 40 and over when your doctor accepts assignment. Even traditional Medicaid programs typically cover these screenings without copays.

However, here’s where many people get caught off guard: mammograms are only free as screening tests for women without symptoms. If you visit your doctor with concerns like a lump or nipple discharge, that mammogram becomes a “diagnostic test.” You’ll likely pay deductibles, copays, or coinsurance just like other medical tests.

When Insurance Costs Add Up

3D mammograms, which provide clearer images and are especially helpful for women with dense breast tissue, may trigger additional fees even with insurance. The estimated out-of-pocket cost is about $50 if your plan doesn’t fully cover this upgrade.

Diagnostic mammograms, which cost an average of $290, often aren’t fully covered by insurance plans. After meeting your Part B deductible of $257 in 2025, Medicare patients pay 20% of the approved amount for diagnostic mammograms.

The Free Program Alternative

The National Breast and Cervical Cancer Early Detection Program provides completely free mammograms to women who qualify. This CDC-funded program operates in all 50 states, six U.S. territories, and 13 American Indian/Alaska Native organizations.

You may qualify if you meet these criteria:

• Age 40-64 (some exceptions for younger or older women)
• No health insurance, or insurance that doesn’t cover screening
• Annual income at or below 250% of the federal poverty level

In 2024, that means you’re eligible if you’re single and earn less than about $37,650, or if your family of four earns less than about $78,000 annually. Check with your state health department for specific income guidelines in your area.

Comparing Your Options

Insurance Route Benefits:

• Convenient scheduling through your regular healthcare provider
• Covers both screening and diagnostic mammograms (with varying costs)
• Results integrated with your medical records
• Access to 3D mammography at many locations

Free Program Benefits:

• Zero out-of-pocket costs for qualifying women
• Includes diagnostic follow-up if needed
• Patient navigation services to help overcome barriers
• If cancer is found, you may qualify for free treatment through Medicaid

Smart Money Moves

Before assuming your insurance route is cheaper, verify these details:

• Whether your plan covers 3D mammography without extra fees
• Your exact copay or coinsurance for diagnostic mammograms
• Whether you’ve met your annual deductible

For many people, the math is straightforward. Sarah, a freelancer earning $35,000 annually, saves $250-300 per year using the free program instead of her high-deductible insurance plan. Meanwhile, Maria, whose employer plan covers all mammography costs, finds the convenience of her regular provider worth staying with insurance.

Additional Cost-Saving Resources

October brings special opportunities during National Breast Cancer Awareness Month, when many imaging centers offer mammograms at reduced rates. The Susan G. Komen Foundation connects you with patient navigators who can identify free screening programs in your area.

Organizations like the National Breast Cancer Foundation offer grants for free mammograms and diagnostic services, while some YWCA chapters provide ENCOREplus programs for women without insurance or with limited coverage.

If you need help with diagnostic mammograms specifically, the Brem Foundation’s B-Fund covers costs for women who can’t afford them and don’t qualify for other programs.

Making Your Decision

Start small by calling the number for your state’s program: 1-800-232-4636. Even if you have insurance, it’s worth comparing costs, especially if you have a high-deductible plan or need diagnostic follow-up.

Remember, screening rates are much higher among women with insurance (74%) compared to those without (37%), but cost shouldn’t be the barrier that keeps you from this potentially life-saving screening. Whether through insurance or free programs, the most important thing is getting screened regularly.

The maze becomes much simpler when you know both paths can lead to the same destination: early detection that could save your life. Choose the route that removes the most barriers for your specific situation.