Here’s how to get insurance coverage for a bone mineral density test (DXA).
Medicare coverage
Medicare Part B* (Medical Insurance) covers bone density test (DXA) as part of preventive screening once every 24 months (or more often if medically necessary) if you meet one or more of these conditions:
- You’re a woman whose doctor determines you’re estrogen deficient and at risk for osteoporosis, based on your medical history and other findings.
- Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.
- You’re taking prednisone or steroid-type drugs or are planning to begin this treatment.
- You’ve been diagnosed with primary hyperparathyroidism.
- You’re being monitored to see if your osteoporosis drug therapy is working.
Medicare will cover DXA for men only under certain circumstances.
* Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Non-Medicare coverage
Many insurance providers will cover the test under certain circumstances as part of their preventive screening benefits. If you are woman younger than 65 or a man younger than 70, any one of the following risk factors puts you at higher risk for osteoporosis and fractures. With any one of these factors, your insurance company should cover a DXA. (Be sure to check with your insurer about your coverage.)
- Early menopause (before age 40)
- Adults with a prior low-impact fracture
- Adults with a disease or condition associated with low bone mass or bone loss
- Adults taking medication(s) associated with low bone mass or bone loss
- Anyone being treated for low bone mass to monitor treatment
- Anyone receiving radiation therapy or chemotherapy for breast or prostate cancer
- Anyone being considered for an osteoporosis drug.
If you find you do not qualify under any of these guidelines, use the American Bone Health Fracture Risk Calculator and determine your risk of fracture for yourself. You will be able to print a color graph that clearly shows your 10-year risk for a fracture and a list of questions to consider when you talk with your health care provider.
Find a DXA center
When you look for a center to get your DXA, find one with a staff who have been trained by the International Society for Clinical Densitometry. Getting your DXA measured by an ISCD-certified technician and read by an ISCD-certified physician ensures a high quality result.
Get your results
FINALLY, make sure that you ask for your DXA report and keep it with your other health records. This report can help you follow your progress whether you stay with the same doctor or move in the future.
Posted: 9/28/2016; Revised: 08/12/21.
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