Unexpected Bills for Mammograms
More than 30 million women receive mammograms a year. Although many thought they were free and preventive, they had big bills. The Affordable Care Law (ACA) provides for free mammograms for women aged 40 and over. However, many are called back for a second look and attributed with unexpected bills for hundreds of dollars.
The Problem of Dense Breast Tissue
In Topeka, Kansas, Sonya Johnson said that she chose her regular mammography and then received a call. The doctors saw something unusual in the pictures. Johnson had a dense breast tissue, a frequent condition. The doctors made an ultrasound on both breasts and found that there was nothing to worry about. But the invoice for the follow-up test was $646, said Johnson.
Lack of Transparency in Billing
Johnson said she had no idea she was being charged. "It is preventive and my first appointment didn’t cost me anything, not even a copayment. So I think you called me and I didn’t expect any bill at all." About 40% of women who deal with mammography have dense breasts and often need a secondary test for which their insurance does not pay.
The Need for Legislation
Johnson is not alone with her $646 bill. A woman in Maryland told CBS News that she paid $350 for additional tests. Another in California said she was charged $912 for an additional test during her routine screening. "Some women are charged for these tests without knowing that they are not covered by her insurer," said Pat Halpin-Murphy.
The Risks of Dense Breast Tissue
The coalition said in dense breasts, mammograms miss more than 50% of the types of cancer present. Laws proposed in Pennsylvania must cover the additional screenings, including ultrasound and MRI for women with dense breasts and others with increased breast cancer risk. "If this is my preventive care and it should be part of my insurance company, I shouldn’t be charged with it," said Johnson.
The Importance of Transparency and Coverage
The coalition said that cancer in women with extremely dense breasts is four to six times more likely, and the coverage of the follow-up tests will cost lives. Without legislation, insurers do not have to cover these tests. Women want to know whether this anomaly in their breast is breast cancer or not, but they should not be charged unexpectedly for additional tests.
