Early Detection Helps in the Fight Against Breast Cancer

With Breast Cancer Awareness Month getting under way this week, it’s a good time to share the preventive services and screening for women at risk for breast cancer.

Coverage of mammograms for breast cancer screening is mandated by the Patient Protection and Affordable Care Act for health plans that started after August 1, 2012. This means you can avail it without a co-pay or deductible. However, this doesn’t apply to grandfathered plans or health plans that were in place before the law was passed.

Many states require that Medicaid, private insurance companies, and public health plans provide coverage and reimbursement for certain procedures and health services. In Oregon, routine screening of average-risk women should begin at age 40, or by referral. Furthermore, the American Cancer Society (ACS) supports these kinds of patient protections and other evidence-based cancer prevention, early detection, and treatment services.

Certain medications that are intended to prevent breast cancer will also be fully covered under Obamacare, in new guidance set to be issued by the Department of Health and Human Services. Women at risk of breast cancer can receive so-called chemoprevention drugs, including tamoxifen and raloxifene, at no extra cost or out-of-pocket expense.

Access to insurance coverage will be available regardless of gender or pre-existing conditions, even for those who change jobs. No one will need to worry about a carrier canceling coverage or being charged more when they receive a cancer diagnosis. Coverage will also be provided for anyone eligible to participate in clinical trials.

If you have a family history of breast cancer or think you are at higher risk, talk to your doctor about screening exams and their potential benefits, limitations, and harms. Remember, early detection can save thousands of lives so make sure you take advantage of these tests that are included in your health coverage.


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