X-rays use electromagnetic waves to generate images of structures within the body. X-rays are used in a number of medical specialties, and almost everyone has had an X-ray at one time or another. Depending on your specific circumstances, Medicare may help cover the costs of your X-rays.
Medicare helps cover diagnostic X-rays that are deemed medically necessary by your physician. Medicare defines “medically necessary” as any standard health care service or supply that is required to diagnose or treat a disease, illness, condition or injury. If your physician prescribes an X-ray for the purposes of diagnosing or treating a health issue you are experiencing, and the use of X-ray tests to diagnose or treat a health issue is considered standard medical practice, you can expect Medicare to cover your service.
What Part of Medicare Insurance Covers X-Rays?
Medicare coverage is divided into four basic parts. Part A (Hospital Insurance), Part B (Medical Insurance) Part C (Medicare Advantage), and Part D prescription drug coverage. If you get an X-ray in a doctor’s office or in an outpatient setting, you will likely pay 20% of the Medicare-approved amount. The Part B deductible will apply. If you get your X-ray while you are an inpatient in a hospital, you may have to pay a copayment.
Many Medicare recipients with Original Medicare Part A and Part B choose to supplement their coverage by purchasing a Medigap policy. If you have Medigap, or Medicare Supplement, coverage, it will help cover the costs that Original Medicare does not, including deductibles, copayments, and coinsurance.
Medicare recipients have the option of enrolling in a Medicare Advantage plan when they become eligible for Medicare. Medicare Advantage (MA) plans are offered by private insurance companies that provide your Part A and Part B benefits. MA plans are required to provide at least the same coverage as Original Medicare, but many provide additional benefits.