Do You Want Insurance Coverage of Mammograms to Continue? Speak Up Now.

Patient Expert

The United States Preventive Services Task Force (USPSTF) will finalize its new recommendations around breast cancer screening and mammograms soon. The proposed update of the 2009 guidelines would result in a small but important change – one that could cost you money.

_Attention, women of all ages – and especially those of you age 40 or older. Do you want insurance coverage for your annual mammogram to continue? Then it's time to make your voice heard. _



Current recommendations from the USPSTF call for breast cancer screening to begin at age 50, rather than at age 40 (as had been recommended by the task force prior to 2009). In addition, the force recommends biennial (every other year) mammograms for women age 50 through 74, rather than annual screening. These guidelines are aimed at women without any known increased breast cancer risk factors, including genetic mutations, strong family history, or previous breast cancer diagnosis.

So, what would change in the new recommendations?

Nothing significant – until you look below the surface, and come across one very important fact.

The new guidelines issue a grade of "C" to mammograms before age 50. Under the Affordable Care Act (ACA), private insurers are required to pay for exams or procedures graded "B" or above. Thus, in the complicated world of government rulings and insurance regulations, these insurers aren't required to pay for mammograms for women younger than 50.

In addition, the task force's "B" recommendation for biennial mammograms for women age 50-74 means insurers are required to pay for mammograms in this group only every other year, not yearly. And, for women 75 and older, the task force's "I" grade means no insurance coverage of mammograms is required at all.

Back in 2009, the government took action to ensure that mammogram coverage by private insurers would remain in place, despite the USPSTF's lack of official endorsement of its efficacy. Today, under the ACA, there's a stronger tie between USPSTF's recommendations and insurance coverage; and there's no guarantee the government would step in this time around, to guarantee continued mammogram coverage.

What can you do?** Visit the USPSTF's Web site and tell them what you think. Comments on the proposed screening guidelines are being accepted through May 18.**

I just left my own comment, as follows: "I would recommend that the USPSTF upgrade the practice of mammograms beginning at age 40 from 'C' to 'B,' in order that women who choose to be screened – despite the known, documented downside of expense, over-treatment, and emotional distress – continue to have their mammograms covered by private insurers. I would also recommend that the current biennial screening of women age 50-74 be changed to annual screening."

Commenting took me all of about 2 minutes. It's an easy process; simply scroll down to the third block on the page, and type in your thoughts, then verify by leaving your contact information (which, the USPSTF says, will remain confidential).

Are you ready? Comment here.

Does one voice make a difference? No. But your voice can easily become one of many voices. And many voices have a chance of being heard. Whether or not you agree with the USPSTF's proposed guidelines, speak up; that's what democracy is all about.

See more helpful articles:

Government Set to Release Newest Mammogram Screening Guidelines

Screening Mammograms Save Lives – But at What Cost?

You're 40 Years Old; Should You Have a Mammogram?

Support for Mammograms – and the Need to Improve Them

Government Softens Task Force Recommendations

Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.