Paying for breast cancer screening

This section provides a brief overview of laws assuring coverage for private health plans, Medicaid, and Medicare coverage of early detection services for breast cancer screening.

State efforts to ensure private health insurance coverage of mammography

Many states require that private insurance companies, Medicaid, and public employee health plans provide coverage and reimbursement for specific health

services and procedures. The American Cancer Society (ACS) supports these kinds of patient protections, particularly when it comes to evidence-based cancer prevention, early detection, and treatment services.

The only state without a law ensuring that private health plans cover or offer coverage for screening mammograms is Utah (see table below). Of the remaining 49 states that have enacted either assured benefits or ensured offerings for mammography coverage, many states do not conform to ACS guidelines and are either more or less "generous" than ACS recommendations. Some states like Rhode Island, however, specifically state in their legislative language that mammography screening should be covered according to the ACS guidelines.

For more information on mammograms and other imaging tests for early detection and diagnosis of breast diseases, refer to the American Cancer Society document, Mammograms and Other Breast Imaging Procedures.

Source: American Cancer Society

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