Breast cancer is the second most common cancer among women in the United States, and the second leading cause of cancer death for women.¹ The good news is that when it’s caught early, breast cancer is often far easier to treat.
If you feel confused about when to start getting mammograms, you are not alone. Breast cancer screening guidelines changed in 2024, and different medical organizations still recommend slightly different starting ages. This guide breaks down the current mammogram guidelines, what the exam actually involves, what Medicare covers, and why early screening matters especially for Black women, who face a significantly higher risk of dying from breast cancer.
Why Breast Cancer Screening Guidelines Matter
Mammograms remain the most effective tool available for catching breast cancer early, often before a lump can even be felt.² Finding breast cancer at an earlier stage generally means more treatment options and better outcomes.
For years, the recommended starting age for mammograms was debated among major health organizations, leaving many women confused about when to begin. In 2024, the U.S. Preventive Services Task Force (USPSTF) updated its guidance, moving the recommended starting age earlier, a change that brought its guidelines more in line with other organizations.³
Breast Cancer Screening Guidelines: When Should Women Start Mammograms
Current guidelines from major organizations look like this:
USPSTF (2024 update):⁴
- Biennial (every other year) mammograms for women ages 40 to 74 at average risk
American Cancer Society (ACS):⁵
- Ages 40–44: Women have the choice to start annual mammograms
- Ages 45–54: Annual mammograms are recommended
- Age 55+: Women can switch to mammograms every 2 years, or continue annually
- Screening should continue as long as a woman is in good health and has a life expectancy of 10 years or more
American College of Radiology (ACR) and Society of Breast Imaging:⁶
- Annual mammograms starting at age 40, continuing as long as a woman is in good health
Because guidelines differ slightly, the most important step is talking with your doctor about which schedule makes sense for your personal risk factors, rather than trying to follow every organization’s recommendation at once.
Why Breast Cancer Screening for Black Women Matters More Than Ever
Black women are diagnosed with breast cancer at a slightly lower rate than white women, but they are about 40% more likely to die from it.⁷ This gap has remained largely unchanged for over a decade.⁸ Among women under 50, the disparity is even wider: young Black women have roughly double the mortality rate of young white women.⁸
Researchers point to several contributing factors, including differences in access to timely follow-up care and treatment, a higher rate of more aggressive tumor types, and disparities in insurance coverage.⁸ Black women are also more likely to be diagnosed at a later stage, which affects survival across every stage and subtype of breast cancer.⁷
This disparity is part of why breast cancer screening for Black women is often discussed as a starting-age conversation to have early and consistently with a doctor, rather than waiting to see if something feels different.
What a Mammogram Actually Involves
A mammogram is a low-dose X-ray of breast tissue used to look for changes that could indicate cancer.² During the exam:
- Each breast is briefly compressed between two plates to get a clear image.
- The exam typically takes about 20 minutes total.
- Compression may feel uncomfortable, but it usually lasts only a few seconds per image.
If your mammogram shows something that needs a closer look, you may be asked to return for a diagnostic mammogram, ultrasound, or other follow-up imaging. This does not automatically mean cancer is present; many follow-up results turn out to be non-cancerous.
What Insurance May Cover for Breast Cancer Screening
Under the Affordable Care Act, most private insurance plans are required to cover recommended preventive screenings, including mammograms, without a copay or deductible when they meet USPSTF guidelines.⁹ Because coverage rules can still vary by plan and state, it’s worth confirming your specific plan’s mammogram coverage directly with your insurer.
Medicare Mammogram Coverage
Medicare Part B covers:¹⁰
- One baseline mammogram for women ages 35 to 39, at no cost
- One screening mammogram every 12 months for women 40 and older, at no cost, with no deductible, when your provider accepts assignment
- Diagnostic mammograms, if medically necessary, covered at 80% of the Medicare-approved amount after your Part B deductible is met
There is no upper age limit for Medicare mammogram coverage, and screening mammograms remain fully covered for women 70 and older.¹⁰
|
Mammogram Type
|
Age
|
Cost Under Medicare
|
|---|---|---|
|
Baseline mammogram |
35–39 |
$0 |
|
Annual screening mammogram |
40+ |
$0 (every 12 months) |
|
Diagnostic mammogram |
Any age, if medically necessary |
Part B deductible + 20% coinsurance |
Medicare Advantage plans are required to cover at least as much as Original Medicare, though it’s worth confirming your specific plan’s network and any added benefits.
6 Steps to Breast Cancer Screening While Getting Insurance Support
Step 1: Know Your Risk Factors Consider your age, family history of breast or ovarian cancer, and any known genetic risk factors. This can affect which screening schedule is right for you.
Step 2: Talk to Your Doctor About Your Starting Age Bring up your risk factors and ask which screening schedule they recommend for you specifically.
Step 3: Confirm Your Insurance Type Check whether you have private insurance, Medicare, or Medicaid, and locate your member services number.
Step 4: Ask About Coverage By Name When you call your insurance plan, ask:
- “Is my annual screening mammogram covered at no cost?”
- “Do I need a referral to schedule this?”
- “What would a diagnostic mammogram cost if follow-up imaging is needed?”
Step 5: Schedule At an In-Network Facility Ask your doctor’s office for a referral to an in-network imaging center to avoid unexpected costs.
Step 6: Ask About Next Steps If Results Are Abnormal Before your appointment, ask what happens if additional imaging is needed, so you know what to expect.
Self-Advocacy Language For Readers
If you want to make sure your risk factors and insurance coverage are part of the conversation, try using these words:
- “Based on my age and family history, when should I start getting mammograms?”
- “I’m concerned about my risk as a Black woman. Can we talk about starting screening earlier?”
- “Is my annual mammogram covered at no cost under my plan?”
- “My mammogram came back abnormal. Can you walk me through what happens next?”
- “I have dense breast tissue. Should I be getting additional imaging along with my mammogram?”
Frequently Asked Questions
Q: At what age should women start getting mammograms?
A: The USPSTF recommends mammograms every two years starting at age 40. The American Cancer Society gives women the choice to start annual mammograms at 40, with annual screening recommended starting at 45.
Q: Why did breast cancer screening guidelines change?
A: In 2024, the USPSTF lowered its recommended starting age for mammograms from 50 to 40, citing evidence that women in their 40s benefit from earlier screening.
Q: Why are Black women more likely to die from breast cancer?
A: Black women are about 40% more likely to die from breast cancer than white women, despite a slightly lower rate of diagnosis. Contributing factors include disparities in access to timely follow-up care, treatment, insurance coverage, and higher rates of more aggressive tumor types.
Q: Does Medicare cover mammograms?
A: Yes. Medicare Part B covers one baseline mammogram for women 35–39 and one annual screening mammogram for women 40 and older, both at no cost. Diagnostic mammograms are covered at 80% after the Part B deductible.
Q: What happens if my mammogram results are abnormal?
A: An abnormal result usually leads to additional imaging, like a diagnostic mammogram or ultrasound. Most follow-up results do not turn out to be cancer, but your doctor can walk you through your specific next steps.
References
- CDC. (2024, September 26). Basic Information About Breast Cancer. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/breast-cancer/about/index.html
- American Cancer Society. (2024). Mammograms. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms.html
- Breast Cancer Research Foundation. (2026, February 10). USPSTF’s New Breast Cancer Screening Guidelines. Retrieved from BCRF: https://www.bcrf.org/blog/uspstf-new-breast-cancer-screening-guidelines-2023/
- U.S. Preventive Services Task Force. (2024, June 11). Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. Retrieved from PubMed: https://pubmed.ncbi.nlm.nih.gov/38687503/
- American Cancer Society. (2024). Cancer Screening Guidelines. Retrieved from American Cancer Society: https://www.cancer.org/cancer/screening/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
- Breastcancer.org. (2026, July 9). Mammogram Screening Guidelines: How Often to Get One?. Retrieved from Breastcancer.org: https://www.breastcancer.org/screening-testing/mammograms/recommendations
- American Cancer Society. (2022, October 3). Breast Cancer Death Rates Are Highest for Black Women — Again. Retrieved from American Cancer Society: https://www.cancer.org/research/acs-research-news/breast-cancer-death-rates-are-highest-for-black-women-again.html
- Breast Cancer Research Foundation. (2025, February 28). Black Women and Breast Cancer: Disparities and Research. Retrieved from BCRF: https://www.bcrf.org/about-breast-cancer/black-women-breast-cancer-disparities/
- American Cancer Society. (2026, April 5). ACS Cancer Screening Guidelines: Complete Recommendations. Retrieved from American Cancer Society: https://www.wellally.tech/blog/acs-cancer-screening-guidelines-2026
- Humana. (2026). Does Medicare Cover Mammograms?. Retrieved from Humana: https://www.humana.com/medicare/medicare-resources/does-medicare-cover-mammograms
