- In the U.S.A, under the Affordable Care Act (Obamacare), insurance carriers are required to cover the full cost of a screening mammogram. A screening mammogram is for women with no symptoms. If the screening is performed by 3D/tomosynthesis mammography, the full cost might not be covered by some insurance companies. It depends on the state in which you live (click here to learn more) and what insurance you have.
- Insurance coverage for additional screening tests after your mammogram, such as Ultrasound or MRI, varies by state and by insurance company. You should check with your insurance carrier(s) to learn if and how additional tests will be covered.
- For women at high risk for breast cancer, most insurers will cover a screening MRI (regardless of density), though a deductible/co-pay may apply, and pre-authorization may be needed.
- A diagnostic mammogram is for women with a sign or symptom of breast cancer, such as a lump or nipple discharge. A diagnostic mammogram is also used if additional mammography views are needed to clear up a question raised on a screening mammogram. A deductible/co-pay will usually apply for a diagnostic mammogram. But again, it depends on where you live and your insurance plan.
In Europe, national breast screening programs for women of average risk are offered in nearly all countries. Variations do exist on the ages and risk factors of women invited to participate in routine screening, how often screening is recommended, and supplemental screening tools used. For specific information by European country, click here.
Learn More:
- 5 Facts Every Woman Should Know
- Video Series: Let’s Talk About Dense Breasts
- Patient Risk Checklist (print)
- Patient Questions and Answers