Diagnostic mammograms

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Etchie
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Date Joined Jun 2007
Total Posts : 6
   Posted 6/7/2007 8:59 AM (GMT -7)   
I want to inform all women that insurance companies won't pay for diagnostic mammograms once a woman has been diagnosted with  breast cancer.  I'm trying to get the law changed.  I need your help.  Please write to your state senators asking that they amend the Mammography Act (Act 148 of 1992) to include payment at 100% for a diagnostic mammogram.  Please spread the word about this important topic.  Thank you.
                                              Bonnie

Etchie
New Member


Date Joined Jun 2007
Total Posts : 6
   Posted 6/7/2007 9:00 AM (GMT -7)   
Please e-mail me if you agree with this situation. Thank you.

barkyboys
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Date Joined Jul 2003
Total Posts : 1564
   Posted 6/7/2007 5:06 PM (GMT -7)   
I have a diagnostic mammogram every year. My insurance never bats an eye about paying. But they don't cover it at 100% unless I've made my deductible for the year. This would be true of a screen mammo as well, though.

Anyone else have problems with this???

BEV

Etchie
New Member


Date Joined Jun 2007
Total Posts : 6
   Posted 6/7/2007 5:35 PM (GMT -7)   
We need to take action to have the insurance companys pay 100% of both routine and diagnostic mammograms. Write to your state senators regarding the Mammography Act (Act 148 of 1992). This act needs amended for the well being of all women. Our state senator is going to check into this. We need all senators to look into amending this act. If enough people write about this, maybe we will get some action.

Bonnie

Tavish
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Date Joined Jul 2003
Total Posts : 2272
   Posted 6/7/2007 6:04 PM (GMT -7)   
To my knowledge, there is no difference in the mammogram whether it is called screening or diagnositc. The difference is in the reason why the mammo is being done. Routine annual? Then it is a screening. To evaluate a possible problem area? Diagnostic.

Deductibles are part of most benefit plans, and if it just so happens that the mammo is early in the year, then the mammo would get the deductible applied.

I had my first diagnostic mammo at 30 and have had at least once a year for the past 8 years. Never had one questioned.

Lori


Etchie
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Date Joined Jun 2007
Total Posts : 6
   Posted 6/7/2007 6:37 PM (GMT -7)   
There is a law that states that a routine mammogram for women age 40 + can have a routine mammogram once a year and the deductible is waived. We need to have that law amended to get the insurance companys pay for a diagnostic mammogram as well, with the deductible waived as well.It is called the "Mammography Act" (Act 148 of 1992). This act needs to be revised for the well being of all women. Write to your state senators about having this act revised. Your help is needed. Thank you.
Etchie

barkyboys
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Date Joined Jul 2003
Total Posts : 1564
   Posted 6/7/2007 7:32 PM (GMT -7)   
Lori, at the breast center where I go, the difference is whether I have the mammogram and leave and get the results later, or whether the radiologist reads the films while I wait. If the radiologist reads the films and wants a compression view after I leave, I have to wait several weeks for another appointment. That is a screening. If I wait for the radiologist to read the films and he wants a compression view, an ultrasound, etc..., we can do it right then. That's what they refer to there as a "diagnostic."

Tavish
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Date Joined Jul 2003
Total Posts : 2272
   Posted 6/7/2007 7:39 PM (GMT -7)   
Interesting, Bev. I'm curious about how that works at other places across the country. Where I go, the radiologist reads it right there, for both the diagnostic and the screenings. I've had both reasons there and it is handled the same each time.

Anyone else have differences in screening vs. diagnostic mammos?

Lori


Etchie
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Date Joined Jun 2007
Total Posts : 6
   Posted 6/7/2007 8:26 PM (GMT -7)   
I am aware of the difference between a routine screening and a diagnostic mammogram. In Penna. where I live there is a law that says ins. companys must pay 100% for a screening mammogram. I feel the law should be amended to have the insurance companys pay 100% for a diagnostic mammogram. I am refering to the Mammography Act (Act 148 of 1992). Both types of mammograms should be paid in full by all insurance company's. I live in Pennsylvania, but this act needs to be amended or put into law in all states. We all pay wayb too much for our insurance premiums and many people are on fixed incomes, as I am. Write to your state senators regarding revision of Act 148 of 1992, please help get the act amended. Thanks

Etchie in Pennsylvania

Candy
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Date Joined Jul 2003
Total Posts : 1294
   Posted 6/8/2007 6:36 AM (GMT -7)   
Exactly who are you Etchie and where do you come from.  I was diagnosed with B/C 4 years ago and I have diagnostic mammo every 6 months.  I have been covered under 3 different insurance plans and they have all paid for the test.  I do have to meet deductables and/or make co-pays but I think that is normal.
 
As others have told you, the only difference is that you wait for the Radiologist to read the films right then and there.
 
I hope that you are misunderstanding, because it took a lot of time and hard work for Breast Cancer patients and survivors to get, by law, the insurance benefits we all need to get well and stay well.
 
Candy
 
 
 
 
Two are better than one, because they have a good return for their work: if one falls down, his friend can help him up.  Ecclesiastes 4:9-10
 


Etchie
New Member


Date Joined Jun 2007
Total Posts : 6
   Posted 6/8/2007 6:44 AM (GMT -7)   
Candy,
I live in Pennsylvania. Mammography act (act 148 of 1992) required insurance companies to waive the deductible for routine screenings. I am hoping that the act will be amended to waive the deductibles for a diagnostic mammogram as well. Every insurance company I checked with, including Medicare, require that a patient meet all deductibles before paying a percentage for a diagnostic. We need to write to our state senators in order to hopefully get the act amended. Not having to meet the deductibles would make a huge difference for women. All I want is for the deductible waived for both types of mammograms. Thanks for responding and I hope all is well with you.
Etchie
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