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Is a mammogram covered under my health insurance?

Keep in mind...
  • Mammograms are considered preventive medicine
  • Most health insurance companies will pay for one mammogram annually free of charge to you
  • Estimates indicate that one out of eight American women will develop some kind of invasive breast cancer at some point during their lifetime

There are a number of medical services that are covered by health insurance companies universally.  In many cases, even the most dangerous of health conditions are avoidable, and illness can be averted if a protocol of disease prevention is followed.

From the insurers’ point of view, proper screening and a swift remedy is more attractive than the potentially high cost of treating a life-threatening infirmity.

Before almost any test or screening procedure is performed, both doctor and patient should assess the likelihood of contracting the illness as well as any side effects imposed by the screening itself.

If you’re wondering whether your health insurance will cover a mammogram, nine times out of ten the answer will be a definite yes. But there are other factors to consider before making an appointment.

An ounce of prevention is worth a pound of cure! Enter your zip code above and start comparing health insurance quotes in your area!

Breast Screening: Covered But Controversial

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Mammography is usually covered under most health plans, including Medicare, once a woman reaches an age determined by the insurer.

In the case of Medicare, a woman is allowed one breast cancer screening every twelve months at no cost to her if the doctor accepts the assignment.

Mammography coverage could be considered a standard of the healthcare industry with most insurers covering women once they reach middle age.

Breast cancer screening has been promoted in recent decades as part of an ‘early detection’ campaign designed to reduce breast cancer mortality. This philosophy argues that time is of the essence when fighting cancer cells.

Estimates indicate that one out of eight American women will develop some kind of invasive breast cancer at some point in their lives. In 2010, there were over 200,000 new cases of breast cancer in women.

Male breast cancer is rare, making up only one percent of breast cancer cases.

That percentage represents thousands of men, most of which have mammogram coverage on their health policies just as women do.

But all-ages mammogram activists are in disagreement with the US Preventative Services Task Force, which recommends that only women ages 50 to 70 should have regular mammograms.

Recent studies have led some scientists to believe that such screening, especially in younger women, may be doing more harm than good.

Radiation Risk of Breast Cancer Screening

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While the of cancer threat posed by contact with the materials used in mammography may be very low, the risk is not zero. Radiation exposure may increase the risk of the tumorous cells that the screening was designed to detect in the first place.

Some studies show that the risk from radiation exposure may be even greater to women of younger ages.

The dose of radiation from a mammogram is the about the same amount that a person receives in three months from the background radiation present in the natural environment.

The negative psychological effects associated with breast screening alone may outweigh the benefits of mammograms.

It’s estimated that one in ten mammograms are false negative. This means that the test failed to detect cancerous growth.

Dense tissue of the breast can often obscure cancer, allowing it to go undetected by the screening. An estimated seven percent of mammograms result in a false positive, which brings the patient back to the clinic for another screening.

However, most insurers will consider each patient’s circumstances, medical records, and family history to determine who is at higher risk of developing cancer.

Many states’ insurance codes require health plans to cover regular breast screening, but only after age 35 or 40.

Now that government-appointed experts are suggesting that mammography may be unnecessary for many patients, insurers may voluntarily listen to advice and discourage screening by denying claims.

Self-Examination for Breast Cancer

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Self-examination  is deemed as an effective ‘early detection’ of breast cancer. Women are urged perform self-examinations on a monthly basis.

A healthy diet with a rich variety of fruits, nuts, grains, and vegetables may be a more effective weapon for combating cancer, as some experts and government agencies are currently promoting.

Carefully weigh the risks of having a mammogram with other factors such as family and medical history before adopting a screening regimen.

Annual screenings may be too frequent for younger women and healthier women of all ages. The question may not be whether your health insurance will cover your mammography but rather a necessary procedure to ensure long-term health?

Stay as healthy as possible by getting your annual checkups! Use our FREE tool to compare affordable health insurance plans today!

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