No one should have to pay expensive out-of-pocket costs to find out if they have breast cancer.
Breast cancer screening mammograms are covered at no cost to most patients with insurance in Virginia. However, if an abnormality is found during screening, or if a patient discovers something on their own at another time during the year, they will need to have additional breast imaging – a diagnostic mammogram, an MRI, and/or an ultrasound – to help determine if they have breast cancer.
Unfortunately, many patients must pay hundreds to thousands of dollars in out-of-pocket costs for breast diagnostic imaging, placing a significant financial burden on those who need this critically important care.
Faced with unexpected and expensive additional medical costs, patients may be forced to postpone or even forgo necessary follow-up imaging, which can result in delays in breast cancer diagnosis and treatment. Early detection and treatment of breast cancer are essential to ensuring better health outcomes. Eliminating expensive financial barriers to accessing diagnostic breast imaging can help save lives.
HB 1243 requires health insurance coverage for diagnostic mammograms, breast ultrasounds and MRIs and prohibits health insurance plans from imposing higher cost-sharing requirements on those breast cancer diagnostic services than screening mammograms. This would protect patients from expensive out-of-pocket costs to access the breast cancer care they need.
Out-of-pocket costs for breast imaging can range from $350 for a diagnostic mammogram to $1,197 for an MRI.
Approximately 12% of women are called back for additional imaging after their routine
screening mammogram.
We Need Your Help!
We know that when legislators hear personal stories from constituents about the impact of a bill, they are more likely to support it. Have you had to pay expensive out-of-pocket costs for a follow-up mammogram, ultrasound, or other diagnostic procedure? Did you choose to postpone the procedure or struggle to cover the cost? We want legislators to hear these experiences and the stress these added costs can place on women (and men) seeking breast cancer care.