Does Medicare or Private Insurance Cover DEXA Scans for Bone Density?

• Yes, Medicare covers bone density DEXA scans in certain cases.
• Medicare Part B covers a DEXA scan every 24 months (2 years) if you meet eligibility criteria.
• In some cases, Medicare will cover the scan more frequently if deemed medically necessary.

Medicare Eligibility for a DEXA Scan

📌 To qualify for a Medicare-covered DEXA scan, you must meet at least ONE of the following criteria:

• Women age 65+ – Routine osteoporosis screening is covered.
• Men age 70+ – Covered for bone density testing.
• Postmenopausal women under 65 with high osteoporosis risk – Must have a doctor’s referral.
• Individuals with a history of fractures – If the doctor suspects osteoporosis.
• People taking long-term steroid medications (e.g., Prednisone) – Due to risk of bone loss.
• Individuals with hyperparathyroidism or other bone disease risk factors.

🚨 Important: Medicare only covers DEXA scans for bone density testing, NOT body composition analysis (e.g., fat & muscle tracking).

👉 Example: If you’re a 68-year-old woman with no fractures or symptoms, Medicare will cover a DEXA scan every 2 years for routine osteoporosis screening.

Does Medicare Cover More Than One DEXA Scan?

• Yes, but only in specific cases.
• If you have osteoporosis, osteopenia, or other risk factors, your doctor can request more frequent scans.
• Medicare may approve annual scans if medically justified.

🚨 If you do not meet Medicare’s requirements, you may have to pay out-of-pocket.

👉 Example: If a 72-year-old man with osteoporosis needs annual monitoring, Medicare may approve a scan every 12 months instead of every 24 months.

What Costs Does Medicare Cover for a DEXA Scan?

📌 Medicare Part B covers 80% of the Medicare-approved cost of a DEXA scan if you qualify.

📌 You are responsible for the remaining 20% unless you have supplemental coverage (Medigap or Medicare Advantage).

• If the scan is performed in a Medicare-approved facility, you’ll only pay the 20% coinsurance.
• If you have Medicare Advantage (Part C), your coverage may vary—check with your plan.

👉 If Medicare doesn’t cover your scan, you may need to pay out-of-pocket.

Does Private Insurance Cover DEXA Scans?

• Most private insurance plans cover DEXA scans for bone density if medically necessary.
• Coverage varies by insurance provider, plan type, and medical necessity requirements.

How to Get Private Insurance to Cover a DEXA Scan

📌 Most private insurers cover DEXA scans if you meet these criteria:

• Women 65+ and men 70+ – Routine osteoporosis screening is covered.
• Postmenopausal women at high risk – Doctor’s referral required.
• People with fractures, osteoporosis risk, or steroid use – May qualify for more frequent scans.
• Cancer patients on hormone therapy – May be covered due to increased risk of bone loss.

🚨 Body composition scans (fat & muscle tracking) are NOT covered by private insurance.

👉 Example: If you’re a 55-year-old woman on long-term steroid therapy, your doctor can request a covered DEXA scan under your insurance plan.

Does Insurance Cover Annual DEXA Scans?

• It depends on your insurance plan.
• Most plans cover one scan every 2 years, but some will cover annual scans if medically necessary.
• A doctor’s referral is often required for frequent scans.

🚨 If your insurance denies coverage, you may have to pay out-of-pocket.

👉 Example: If you have osteopenia or osteoporosis, your insurance may approve a DEXA scan every 12 months instead of every 24 months.

What If Medicare or Insurance Won’t Cover Your DEXA Scan?

If Medicare or private insurance won’t cover your scan, you can:

• Pay out-of-pocket – Costs typically range from $100-$250 per scan.
• Use an HSA/FSA account – Some facilities accept HSA/FSA funds for bone density scans.
• Check for cash discounts – Some providers offer lower rates for self-pay patients.
• Consider alternative financing – Some clinics offer payment plans.

🚀 KALOS in San Francisco offers affordable DEXA scans, even if insurance doesn’t cover it.

How Much Does a DEXA Scan Cost Without Insurance?

📌 Typical Pricing for DEXA Scans:

• Average Cost Nationwide: $100 – $250 per scan
• Cost in Major Cities (Like San Francisco, NYC, LA): $150 – $300 per scan
• Multi-Scan Packages Can Reduce Per-Scan Costs

🚀 Compared to insurance copays and hospital costs, a one-time DEXA scan is often the more cost-effective choice.

The Bottom Line: Does Medicare or Private Insurance Cover DEXA Scans?

• Medicare covers bone density DEXA scans every 2 years for women 65+, men 70+, and high-risk individuals.
• Private insurance covers DEXA scans for osteoporosis screening but may require a doctor’s referral.
• Insurance will NOT cover body composition scans for fat & muscle tracking—you’ll need to pay out-of-pocket.
• If insurance won’t cover your scan, you can self-pay ($100-$250) or use HSA/FSA funds.

🚀 If you want accurate bone health tracking without insurance hassles, paying out-of-pocket for a DEXA scan is a smart investment.

Book Your DEXA Scan in San Francisco at KALOS Today

Looking for a hassle-free way to measure bone density or body composition? KALOS offers state-of-the-art DEXA scanning in San Francisco for osteoporosis screening, fat loss tracking, and muscle monitoring.

📍 Schedule your DEXA scan today at KALOS—because real data leads to better results.

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