What do I do when I am UNDER 40 and have a high risk of Breast Cancer?
The Affordable Care Act (ACA) requires health insurance companies pay for up to one screening mammograms per year for women ages 40 and over. This leaves women under 40 without the guarantee of a free mammogram.
In order for an insurance company to pay the cost of a preventative mammogram, MRI, or ultrasound, women under 40 will be required to demonstrate that they are at a high risk of Breast Cancer. In most cases, you will need to document a family history of breast cancer. Different insurance companies require different additional information to substantiate the need for preventative scans. The appeals process can be tedious and time consuming, but getting that mammogram, MRI, or ultrasound paid for IS possible. You will need to get your doctor onboard, and you may need to make multiple contacts before coverage for a preventative scan is approved – but if you don’t have the cash to pay for preventative services, appealing the process is worth the effort.
If you are under 40 and have a high incidence of breast cancer in your family or if you have had genetic testing that reveals you are at an increased risk of breast cancer, contact your insurance company to determine the information they require.
If you can't get your mammogram approved, there are organizations who may be able to help you locate free or discounted services.
freemammograms.org is one of many resources that can help you locate clinics and facilities that provide free mammogram and other diagnostic procedures for women at little or no cost.
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