Women are surprised when they receive a bill for their second mammogram in the mail, even though their first mammogram was covered by insurance.
Around 30 million women every year receive preventative mammograms. Mammograms are necessary for the early prevention of breast cancer. Every 2 minutes, a woman is diagnosed with breast cancer in the United States. Mary Smania, a nurse practitioner at Michigan State University’s Department of Surgery, explains that mammograms “can detect cancers when they are very, very small, and so … the benefit of mammograms … the outcomes are better because women are diagnosed at an earlier stage.”
Around 40% of the women who go for their annual mammograms have dense breast tissue and need to go for a secondary mammogram. However, the Affordable Care Act only provides free mammograms every one to two years for women ages 40 and over. Therefore, if a woman needs to be called back for a secondary mammogram test, it will be out of pocket.
Pat Halpin-Murphy, head of the Pennsylvania Breast Cancer Coalition, said, “Some women are charged for these tests without knowing that it’s not covered by their insurer. But women want to know whether that anomaly in their breast is breast cancer or not, so they say, ‘Okay, I’ll take the additional screenings test’ and then they get these enormous bills, and they can’t pay them … That’s unreasonable and I think unconscionable and we want to change that.” A bill for a second mammogram can be range anywhere from around $350 to $950.
Some local organizations have been trying to help women in this situation. Michigan State University’s nursing program has launched its Pink Impact Breast Care Program to help those who are under-insured or uninsured, and to help cover the services that are not covered by the Affordable Care Act. The center will offer mammograms at the low cost of $50. Smania talked about a scenario where a woman “might have their screening mammogram and they have an abnormality, and then they need further testing, and that’s all out of pocket … so we will cover the biopsy or the ultrasounds that’s needed to further investigate what’s going on with the mammogram.”
Breast cancer when detected early can be mostly treatable, but, as Smania describes it, “we all know that women are going to put food on the table, they’re going to get that backpack for their kids for school, and they are going to put off doing things they might need for their own care.”
Sources: CBS 10/31/19, WILX 10/04/19