Mammogram Referral Requirements: What You Need to Know

In most cases, a referral from a doctor or healthcare provider is required to obtain a mammogram. Because mammograms are classified as medical procedures, insurance typically does not cover them without one.

Exceptions

• State programs: Some states offer free or low-cost mammograms without a referral for women over a certain age.
• Insurance provisions: Certain plans cover mammograms without a referral if deemed medically necessary.

If you're unsure whether you need a referral, contact your doctor or insurance company directly for clarification.