Is Your 3D Mammogram Covered?Published on November 1, 2016.
By William F. Muhr, Jr., M.D., D.A.B.R., President, South Jersey Radiology
The research is clear – 3D mammography saves lives by enabling earlier detection of potentially life-threatening cancers. The technology reduces unnecessary callbacks and provides peace of mind.
As these benefits become more widely known, many women are requesting the procedure and asking, “Will my health insurance cover 3D?”
For now, the answer varies.
Medicare began covering 3D mammography in January 2015 following an exhaustive analysis of the science. But what about private insurance companies? In August 2016, Cigna revised its previous medical coverage policy to cover 3D mammography for routine breast cancer screening for all women aged 40 and up. (Previously, the company covered 3D mammography for diagnostic purposes, but not for annual screening.)
Kudos to Cigna for stepping up. In the press release announcing the new coverage decision, Cigna cited guidance from the National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of leading cancer centers. Cigna also stated: “We have a responsibility to our customers and clients to ensure that the medical treatments, tests and procedures they’re paying for have proven clinical value and will help improve their health and well-being. That’s a responsibility that we don’t take lightly.”
Unfortunately, most New Jersey insurance payors are behind the science on this issue and out of step with coverage guidelines. It’s only a matter of time before they catch up but in the meantime, don’t let their decisions discourage you from getting a 3D mammogram.
And don’t be afraid to ADVOCATE FOR CHANGE! Pick up the phone and contact your health insurance company and let them know how important it is for mammograms to be covered by insurance. Early detection can prevent over treatment and ultimately saves the insurance company money. We know. A 3D mammogram is the latest technology for earlier detection.
Advocacy likely played a role last year when Pennsylvania became the first state in the nation to require that 3D mammograms must be covered at no cost to women in the same manner as traditional 2D mammograms. In announcing this change, Pennsylvania Governor Tom Wolf stated: “This modern technology is offering new opportunities for physicians to diagnose breast cancer in women and provide life-saving treatment earlier than ever.”
As we always say at SJRA, early detection saves lives!
Dr. William F. Muhr is President and CEO of South Jersey Radiology Associates (SJRA) in the greater South New Jersey & Philadelphia area. SJRA offers a full spectrum of state-of-the-art imaging technologies. Dr. Muhr, an expert in Diagnostic Radiology/MRI Body, received his undergraduate degree from Lehigh University and his M.D. from Hahnemann University, completing both his internship and residency at Hahnemann University Hospital.