Expanded Coverage for Diagnostic Mammograms

You went for your annual screening mammogram. A few days later, you get a call from the breast center, and you’re told that the radiologist recommends that you come back for some additional testing. Is it cancer or just a reason for caution? It’s a call that can put fear in your heart, and potentially a dent in your savings account. Unfortunately, for many women, the cost of follow up breast imaging can be a huge deterrent to receiving the proper and timely diagnosis.

This additional breast imaging that follows a screening mammogram is called a diagnostic mammogram or a diagnostic ultrasound. Traditionally, in Illinois, patients with private insurance could pay more than $500 to $600, out-of-pocket, for diagnostic imaging. Thankfully, a new state law that went into effect on January 1st, 2020, will require many insurers to fully cover the cost of diagnostic mammograms. Patients who are members of self-funded insurance plans will be excluded. I am hopeful that this will eliminate the burden of cost for many women who desperately need the vital information diagnostic breast imaging offers. If you have any questions if this new law has amended your current health insurance policy, I encourage you to contact them directly.


Hope Placher, PA-C