The passing of the Affordable Care Act in 2010 made prevention more affordable and accessible by requiring health plans to cover preventative services and eliminating cost sharing for those services. The impact was greatest among patients with lower income who had high cost-barriers to screening prior to the ACA.
A recent study even found that women in the lowest income group became more likely to get a screening mammogram after the ACA.
This all sounds like good news, right? Sort of…
The problems arise in the follow-up. If a patient receives abnormal results from their screening mammogram or has a history of breast cancer, their doctor will likely recommend a diagnostic test (i.e. diagnostic mammogram, ultrasound, biopsy, etc.). Diagnostic tests aren’t cheap.
The average patient pays $349 for a diagnostic mammogram and $1,197 for a breast MRI.
While that cost may be minute to some, to others it can mean not paying rent or missing a car payment.
Over the past few months, we conducted research on behalf of Susan G. Komen to better understand this important issue.
We interviewed real women experiencing these costs and here’s what they had to say:
“[My doctor] wants me to do a Diagnostic Mammogram…I asked them about out-of-pocket charges…I would have to pay $430 and that doesn’t include radiologist charges and other separate charges. This really pisses me off because they want us to do screening each year but then the cost is getting higher which makes it pretty hard to afford.” – Stephanie from Cyprus, TX
“I’m a 14-year breast cancer survivor, so you think I’d be able to afford at least a yearly mammogram. But Obamacare is terrible. It doesn’t cover hardly anything. I’ve been waiting a few years to get checked again because in March I qualify for Medicare and I’ve heard that’s better.” – Annie from Wylie, TX
“It’s already a really scary process—finding a lump, getting tested, waiting for results…wondering if I’ll be paying off my bills for the next few years is just the icing on the cake. It’s a lot to handle.” – Raechael from Chino, CA
“I have extremely dense breasts and every time I have a mammogram or a breast exam, the technician or medical personnel comments that I would be better off having a 3D mammogram. Since my insurance won’t cover a 3D until the regular mammogram comes back in question, the cost-prohibitive 3D exams will not be covered, so I haven’t had one. – Theresa from San Francisco, CA
“I had to go around to almost a dozen different local doctors to find one who would fight for me and try to get me a lower price for the ultrasound. Most accepted that the screening mam was all that would be covered.” – Lo from Maitland, FL
And that’s just a few of the testimonials we received. Women all over the county are frustrated, scared, and often postponing diagnostic imaging due to cost.
Susan G. Komen is doing everything they can to make this right and we are proud to fight by their side in the battle to reduce the out-of-pocket costs for diagnostic imaging.
For more information on this study, please contact us.
