Amerigroup texas mammogram

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Medicare Medicare covers 2D and 3D Tomosynthesis screening mammography for female recipients as a preventive health measure for the purpose of early detection of breast cancer.

Medicare will pay for a screening 3D Tomosynthesis Mammogram with no out of pocket expense for patients. Medicare does not pay for screening mammograms for female beneficiaries younger than Medicare will pay for one baseline mammogram for female beneficiaries between the ages of 35 and Medicare covers screening mammography for women age 40 and over on a once per calendar year basis. Once a woman reaches age 40, a screening mammogram has to have occurred at least 11 months after the last covered screening mammogram.

Medicaid NC Medicaid covers 2D and 3D screening mammography for female beneficiaries as a preventive health measure for the purpose of early detection of breast cancer. Medicaid will pay for one baseline exam within the five years.

Women 40 years and older. Medicaid will pay for one exam annually. Her friends wanted to know, "Will my insurance cover my 3D mammogram? What I found was surprising - especially considering the vast amount of research that has already been published regarding the effectiveness of digital breast tomosynthesis in reducing callbacks from questionable findings and detecting more early stage cancers.

This particular study sampled nearly half a million patients and is the largest study on digital breast tomoysnthesis known to date. The results were quite impressive:. Tomosynthesis has been shown to improve key screening parameters compared to digital mammography. The College applauds the decision by the Centers for Medicare and Medicaid Services CMS to facilitate access to these exams by covering beneficiaries for tomosynthesis and urges private payers to do the same.

That's right - Since January 1st , Medicare and Medicaid in some states covers payment for screening digital breast tomosynthesis mammograms. Since most private insurers traditionally follow Medicare coverage policies, this could be a good sign! You should consult with your insurance company before getting a 3D mammogram. If you're not covered, don't let it dissuade you from getting your exam, even if you may have to pay a little extra out of pocket for the time being as some clinics may charge for the extra 3D portion of the mammogram.

While it may be an inconvenience, the benefits of this exam and its potentially life-saving capabilities to help detect a cancer in its earliest stages are certainly worth the fifty dollars or so until insurance companies catch up to the rest of the world and see the value in these exams.

In the meantime, you can advocate for yourself and the women you love. Write your insurance companies. Share with them the JAMA study and ask why half a million patients is enough clinical evidence to justify coverage through Medicare and Medicaid, but not with them.

Editor's Update November 13, Progress has been made in coverage since this article was first published. In addition to Cigna being the the first major insurer to cover 3D mammography, on January 1, , the state of Texas will join Arkansas, Connecticut, Illinois, Kentucky, Maryland, New Jersey, and Pennsylvania in mandating insurers to cover the cost of 3D mammograms.

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