If you are over 45 years or a younger woman with high risk of breast cancer, it is recommended to get mammograms every year. By definition, mammograms are x-ray images of breasts that are used to screen for signs of breast cancer. Mammograms can be done for screening (routine checkups) or diagnostic (if there are signs of breath cancer) purposes.
The Cost of Mammograms Screenings
Determining the cost of a mammogram can be complex. A wide range of insurance health plans include preventive health services such as mammograms. However, you may still be charged for some services that are done during the mammogram screening. For instance, you can be charged if the following happens:
• If cancer is detected and eliminated during the mammograms (this is commonly referred to as biopsy. Again, if you opt for colonoscopy screening and a biopsy is needed, the health facility may use a different billing code that’s likely to convert the procedure into “therapeutic” instead of screening.
• If mammogram is part of a diagnostic process following a biopsy or if mammogram is performed to evaluate a problem
• When you are high risk of breast cancer and may need frequent screenings than average risk adults.
So, whether or not your mammogram screening is 100 percent covered will ultimately come down to the medical code that the health care facility uses when billing you for the procedure. In case your doctor finds something unusual during mammogram screening, they are likely to order for diagnostic mammogram. This involves looking into more detailed images and may expose you to slightly high doses of radiation. It can be more complicated when your free preventive exam turns into diagnostic exam and you end up with extra medical charges.
Minimizing Mammogram Costs
Here are the best practices to help you save on mammograms:
• Ask the doctor the amount of the mammogram cost that will be covered. Ask whether the coverage will include visits and the screening procedure. You also need to establish whether the amount could change based on the findings during the procedure.
• Double-check with your insurance provider before you go for the procedure—ask about costs like copays, co-insurance, and deductibles.
All women need to go for mammogram screenings at some point in life because early detection of breast cancer and other breast conditions can be life-saving. However, as highlighted, the costs of mammogram screenings are dictated by a lot of factors. Accordingly, consult your doctor or a mammogram specialist to guide you on the amount that you are likely to pay for the procedure in your area.
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