Health plans will still pay for under-50 mammograms

Recently, a group of independent physicians proposed new guidelines for mammograms that have generated a significant amount of controversy. Rather than getting regular screenings after age 40, the group changed its recommendations to embrace women ages 50 and over, as risks outweigh benefits for younger women, members said.

While health plans are often the first to jump on new guidelines that favor them financially, this time it doesn't seem to be happening. If nothing else, federally-backed plans are not planning to change coverage standards, according to HHS Secretary Kathleen Sebelius.

Commercial health plans have weighed in to reassure women in their 40s, too. For example, Kaiser Permanente, Aetna (AET), CIGNA (CI), Geisinger Health Plan, Group Health Cooperative and WellPoint (WLP) told USA Today that they had no current plans to change mammogram coverage.

Realistically, low reimbursements pose a bigger threat to women's mammogram access than policy debates like these, according to an analysis by The New York Times. With Medicare mammogram reimbursements at around $95, and commercial payers coming in only slightly higher, the number of imaging centers willing to conduct mammograms is falling, the newspaper reports.

Find out more about reactions to the new guidelines:
- read this Kaiser Health News piece

Related Articles:
SPOTLIGHT: Task force recommends delaying mammograms
SPOTLIGHT: Want women to get tested? Throw a mammogram party
Report: Breast cancer rates fall 2 percent per year

Post a comment