Per the Affordable Care Act, annual preventative mammograms are covered by all new plans; however, covered and paid is not the same. Many patients at risk, are left to pay for their own annual testing.
Why is this important?
In managing physicians AR, we speak to a lot of desperate patients who are not clear on what is paid by insurance and what is not. For patients with family or personal history of breast cancer or other breast problems, annual mammograms are not always paid by insurance. When presented with these issues, a diagnostic mammogram is done annually instead of a screening; even though, diagnostic annual mammograms may be covered,they are subject to the patient's deductible and not necessarily paid by insurance. What is more appropriate during this breast cancer awareness month than for us to step up and take action for these at risk patients. A mammogram once per year, regardless if annual screening or if an annual diagnostic, should be considered an annual preventative test with no applicable copay or deductible and covered and paid by insurance at 100%.
