In addition, most states have laws on the books requiring health insurers to pay all or part of the cost of screening mammograms, according to the National Cancer Institute. Insurers that do business in a state must abide by the law.
However, according to an annual survey by the Henry J. Kaiser Family Foundation and Health Research & Educational Trust, more than half (57 percent) of all employees receiving health-care coverage from an employer are in "self-funded" plans, and these plans are exempt from state laws.
Medicare, the federal health program for older and disabled Americans, covers annual mammograms starting at age 40, and, according to a statement from Health and Human Services Secretary Kathleen Sebelius, that won't change. On Thursday, she urged women to "keep doing what you have been doing for years."
"That's reassuring," acknowledged Joanna Morales, director of the Los Angeles-based Cancer Legal Resource Center, "but we definitely don't want to see a movement by private insurance companies to try to use these guidelines as an excuse to continue to reduce access to care for women."
The national average price for a mammogram is $105, including the cost of the X-ray and the physician's fee for interpreting the results, according to Healthcarebluebook.com.
"That would represent what most providers accept from insurance companies as payment in full," explained Dr. Jeffrey J. Rice, chief executive officer of the online pricing guide. However, providers may not honor that rate if insurers decide not to cover mammograms before age 50, and in that case, women could be billed upwards of $400, he said.
Minneapolis-based UnitedHealthcare said in a stateme
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