The Affordable Care Act (Obamacare) required payers to completely cover a screening mammogram for each woman over age 40. This was intended to look for breast cancer in women with zero symptoms at average risk for cancer.
Sounds great, no?
But what happens when additional DIAGNOSTIC testing is needed: ultrasound or 3Dmammograms? The so-called “recall rate” averages up to 10% per screening mammogram, and each woman can anticipate up to a 50% personal risk of recall after one decade of regular screening.
My patient this week in clinic was LIVID when telling me about this scenario happening to her. She was given a bill for $1,000.00 by our large local hospital system. Some insurance payers cover the additional testing but many, including Medicaid do not.
Before ordering an annual or biannual mammogram with your doctor, ask if your #screening test should be a routine 2-D mammogram or a 3-D mammogram (tomosynthesis).
Consider requesting a “SCREENING 3-D MAMMOGRAM” if your last mammogram required additional testing or you have dense breast tissue. Even if the 3D is not covered by your payer for screening, the same local hospital system will only send you a bill for $90, according a local breast radiologist I asked this week. Sure beats $1,000!!