You discover a lump or other breast abnormality?
One step you can take towards early detection of breast cancer is performing regular breast self- examinations. But what happens when you find a lump?
First, and perhaps the most difficult, try not to panic. Most breast abnormalities are NOT cancer. Most are caused by some other benign condition. While I know the situation is frightening, remaining calm and optimistic will help you focus on the next steps. Remember, most anomalies are not cancer, and the sooner you get this checked out, the sooner you will know exactly what you are dealing with.
Next, contact your physician, let them know what you’ve found, and schedule an exam.
But don't be caught by surprise. Once you find a lump or other abnormality, your breast exam and subsequent mammogram, MRI, or ultrasound becomes diagnostic and will NOT be covered under the Affordable Care Act (ACA) preventative mammogram benefit. If you're insured, most often the cost of your examination and any subsequent diagnostic scans will be applied your health plan deductible and coinsurance.
If you want to stretch your healthcare dollars, while waiting for your doctor's appointment, start comparing prices for diagnostic examinations. This may require several telephone calls, but the difference in cost varies substantially between facilities and is worth your investment of time. Since you won’t know exactly what your doctor is going to order, ask about both 2D and 3D mammograms because your doctor will most likely schedule one of these.
First, check the cash price.
How much would your mammogram cost if you don't run it through your insurance?
(The facility does not necessarily need in-network if you are paying cash.)
Then, ask how much you will have to pay towards the cost of your mammogram if you run it through your insurance.
To do this, it is very important to confirm that the facility you are considering is in-network with your specific insurance plan. Use these words:
"Are you contracted with my insurance plan?"
The provider will need the information from your insurance card, so be sure to have it available. Medical providers take or accept almost all insurance. This doesn't mean they are contracted and in-network. The difference effects your hard-earned dollar.
If you end up paying cash for your scan, understand that what you spend will NOT accumulate towards your insurance deductible. Sometimes the price difference is significant enough that you might choose to pay cash anyway. In addition, if you don't think you’re going to meet your deductible and annual out-of-pocket maximum for the year, by all means, pay cash and save your money.
Pro tip: It may shorten your search to know that, as a general rule, free standing facilities are often less expensive, while mammogram facilities connected to a hospital are usually more expensive.
Don’t let fear of having to meet a deductible prevent you from scheduling the examination you need. While most breast abnormalities are not cancerous, when cancer does occur, early detection increases treatment options, overall survival, and quality of life.
If cost is preventing you from receiving the medical care you need, these resources might help:
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.
Several national cancer support organizations offer financial assistance or access to free mammograms.
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