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The New Mammogram Guidelines and What They Mean to Your Health Insurance

Recently the US Preventative Services Task Force came out with its new recommendations on getting mammograms that shocked the entire nation. The new recommendations are to have women not start receiving mammograms until the age of 50 and then get them routinely every other year. This is a far cry from whatHealth insurance for mamograms everyone is used to, which is a mammogram once per year starting at the age of 40. This has raised concerns that some or all health insurance companies will now back out of covering routine mammograms. Is this going to be the case? 

As you view this article you have to keep in mind that the concerns herein are pertaining to routine mammograms. If you are at high risk for breast cancer or have a history of lumps and cysts then anytime you get a mammogram it is not considered routine and should therefore always be covered by your health insurance coverage plan so long as it is coded in the proper manner. 

If you discover a lump you should schedule an appointment with your doctor immediately. Don't wait just because it has been less than a year since your last mammogram. This is a medical necessity and should be covered by your health insurance coverage.  

It is also important to note that the Task Force has only made recommendations, not mandates. Because of that, these are not policies that have to be followed to the letter. The news has garnered some major coverage though and many well-respected doctors, the American Cancer Society, and breast cancer advocates such as Susan G. Komen for the Cure have come out and said that they do not support the new guidelines and that they will continue to recommend their current guidelines. 

Many health insurance companies are following suit. They recognize that mammograms are a great way to help in the early detection of breast cancer. Why is that important? Anyone who knows anything about breast cancer knows that early detection is the key to gaining control over the disease and women that detect breast cancer early on stand a much better chance of surviving their ordeal. Still other insurance companies say they will review the new recommendations by the Task Force but also say they will take into account what physicians and other top organizations are saying as well. 

Directly after the Task Force announced its new recommendations, Kathleen Sebeilius, Secretary of US Health and Human Services announced that she recommended women continue to get annual screenings done starting at the age of 40. Additionally, Medicare will continue to pay for annual mammograms for women in the program starting at age 40. 

Before you fly off the handle and think that your health insurance provider will no longer cover the cost of your annual mammogram, give them a call and ask. If they do make such a significant change to your policy they will have to give you plenty of notice. 

Still this is a concern for women of all ages. Just looking at the numbers, breast cancer affects many women under the age of 50. Talk with your doctor and your insurance provider today and keep up to date on this very important event.

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