Mammographies Made Cheaper Through Obamacare

Local health insurance experts weigh in on the Affordable Care Act's impact on the cost and access to mammography and other preventive cancer screenings.

Like other types of cancer, early detection is one of the most important factors in successfully fighting breast cancer.

Now, mammographies are available through most private health plans without requiring a co-pay, co-insurance or other type of cost-sharing. This change, which effects insurance policies renewing on or after August 2012, was made under the Affordable Care Act, also known as Obamacare, which was signed into law in 2010.

This new insurance change is significant because studies show copays – even moderate copays – for mammograms and Pap smears are enough to deter women from obtaining these screenings, according to the U.S. Department of Health and Human Services.

In Wisconsin, it seems most health insurance plans already covered mammography and other preventive cancer screenings. Of the 12 health insurance providers represented by the Wisconsin Association of Health Plans, very few major benefit packages required co-payment on behalf of the patient, said Phil Dougherty, the organization's senior executive officer.

“Preventive services should be offered with zero cost-sharing so there is no barrier whatsoever to accessing these services,” Daugherty said.

However, some larger companies that offer their own insurance benefits were previously requiring their patients to pay for mammographies, according to Terrence Frett, the president of Frett Barrington Ltd., a health insurance consulting firm based in Pewaukee.

That’s significant because 60 percent of people who receive health insurance through their employer are through these larger, self-insured companies, according to a study conducted by the Office of the Commissioner of Insurance.

"The primary change is uniformity of coverage," Frett said. "It doesn’t matter if it’s a large employer providing their own benefits or a small company purchasing health care from United Healthcare, for example. Now, there is some consistency of the same preventive services to be covered, as outlined by the government."

It's still a little early to determine if free mammography coverage is changing the number of people that are going to their doctor for a breast cancer screening. Frett said he sees this aspect of the Affordable Care Act as a positive change, and he hopes it lowers any barriers that may be stopping people from seeking preventive cancer screenings.

“I wish people would take the initiative to seek out these preventive care services. That’s the challenge we continue to face," Frett said. "We can cover screenings all we want, but if people don’t take the initiative to go to the doctor’s office then it doesn’t help anything.”

Other preventive women's services covered by Obamacare include:

  • Well-woman visits
  • Screening for gestational diabetes, which help protect the mother and her child from one of the most serious pregnancy-related diseases
  • Breastfeeding support, supplies and counseling
  • Screening and counseling for interpersonal and domestic violence
  • Contraception and contraceptive counseling
  • HPV DNA testing
  • STI counseling
  • HIV screening and counseling
Denise Lockwood October 27, 2012 at 03:04 AM
What's really interesting... is that I've had maybe two conference calls with Ariana and my colleagues in the last 18 months. She hardly makes editorial decisions for us.
Heather Asiyanbi (Editor) October 27, 2012 at 03:12 AM
@Denise - what, you don't talk to Ms. Huffington daily like the rest of us?! *massive eye roll* People - either insurance companies pay for preventative care, which is far cheaper in the long run and makes good business sense - so why they just don't on their own is a mystery - or insurance pays BIG for diagnostic tests and treatment which is far more expensive and then passes all those elevated costs on to ... wait for it ... everyone else.
Heather Asiyanbi (Editor) October 27, 2012 at 03:14 AM
@AWD - so funny considering Denise Lockwood and I will be covering a large Racine County Tea Party event tomorrow and Patch will cover Mitt Romney's visit on Monday.
Craig October 27, 2012 at 03:36 AM
Fitting...Barry the boob! I'll be glad to see him go, thanks for the mamories Obama.
Keith Schmitz October 27, 2012 at 05:04 AM
Ladies, you are confusing our right wing friends with facts.
Keith Schmitz October 27, 2012 at 05:06 AM
Actually more articles like this mean more women will become aware of these services and find out about these conditions early -- before they become more costly, and more deadly.
Keith Schmitz October 27, 2012 at 05:07 AM
Saw a tweet that read, "some people would rather get screwed by corporations than helped by the government." Especially a government headed up by a black man. This so called BS is saving lives.
Craig October 27, 2012 at 05:33 AM
Scmitzie: Get a mammogram of your brain and Pay Hoffa his fifty!
Craig October 27, 2012 at 05:35 AM
Keith wants more articles about free food, he is always looking for a handout.
Annie Nominous October 27, 2012 at 06:13 AM
Heather - the hard-working tax payers will be paying for these "free" services which ObamaCare promises. Why do many Americans believe that health care should be free or cover all things...what ever happened to personal fiscal responsibility? Meanwhile, many people who receive government assistance have fancy televisions, cable, smart phones, etc. And how about the doctors who are receiving less and less reimbursement for their services from the government for Medicare? Something has to give and losing great doctors is not the solution. The liberals try to promise all things "free" to their voter base! Hard-working people have been funding "healthcare for all" for many years, hence the high premiums. Your headline is very misleading and propaganda!
Annie Nominous October 27, 2012 at 06:14 AM
*massive eye roll* back at you, Heather.
Annie Nominous October 27, 2012 at 06:19 AM
Heather...one more point. Have you ever witnessed the inefficiencies at the VA Hospital (government-run)? Great doctors and nurses work there, and the patients are wonderful people, but there is no comparison to the private hospitals as far as efficiency. The government takeover of healthcare should scare everyone. Read the UK newspapers for a week and you will know what I mean. Check out the Daily Mail online for a start.
Jeff Rumage October 27, 2012 at 03:27 PM
@Mike in OC: I can understand your concerns about bias, so let me provide some context. Patch has been running a series of articles for breast cancer awareness month, and to provide a resource for our readers, we decided to take a look at how Obamacare affects mammography coverage. In searching the internet and doing research, it seemed there were many people who were curious about this issue but were unaware that cost-sharing was not allowed in plans renewing on or after August 2012. It may not have the political angle Patch readers are looking for, but I think it sharing a resource for women about a recent change in mammography policy during breast cancer awareness month is a positive thing.
Bob McBride October 27, 2012 at 03:33 PM
Jeff, While you're around, how about disposing of zyl350 below....
3393 October 27, 2012 at 07:39 PM
@Annie- you nailed it! @Heather- my insurance rate has gone way up and Obama said it would go down. Hmmm, I wonder why? I'd love some research on that story. I know the Patch will cover that, right?
Randy1949 October 27, 2012 at 07:44 PM
It's disheartening to see the inevitable degeneration of this thread into partisan hate. All of it is beside the point, because until 2014, our family pays the full price out of pocket for mammograms, pap smears, and annual physician exams. All this fuss over a co-pay.
Randy1949 October 27, 2012 at 07:48 PM
@Nuitari -- $300 for a screening mammogram. Closer to a thousand all told if they discover something suspicious and follow-up studies are required. Is you wife worth it? I hope so.
The Anti-Alinsky October 27, 2012 at 08:05 PM
I have heard the accusations that the Patch is left-wing and right-wing. While the individual reporters and bloggers may have a slant, I believe that both sides are free to write what they feel, provided they don't step over a certain line. As far as confusing the Right with facts, maybe you can clarify one for me Keith... Have you paid Hoffa his 50 bucks yet? (that was just to P155 off Bren)
James R Hoffa October 27, 2012 at 09:15 PM
@Jeff Rumage - Have the costs associated with Mammographies for insurance providers gone down because of Obamacare? If not, then who's making up for the difference if it's not the patients via co-pays? Don't you think this info is vital to the validity of your article and headline?
James R Hoffa October 27, 2012 at 09:18 PM
@low life POS scum bag Schmitzy - What do you know of facts - you can't even make good on your outstanding liabilities!
James R Hoffa October 27, 2012 at 09:21 PM
Has the cost of these procedures decreased because of Obamacare? If so, how? If not, then who's making up for the cost difference if it's not patients making co-pays? Nothing is free and this 'article' leaves out a lot of very vital FACTS.
Jay Sykes October 27, 2012 at 09:31 PM
Does the headline 'Cost for Mammograms the same;costs shifted thanks to Obamacare' work for you JRH?
James R Hoffa October 27, 2012 at 09:40 PM
@Jay - That's more like it, as long as the article explains who the cost was shifted to.
Heather Asiyanbi (Editor) October 27, 2012 at 10:02 PM
@Annie - my eye roll was directed at those who think Ariana Huffington makes our editorial decisions. But the facts remain - patients who get care before something catastrophic happens cost EVERYONE less in the long run. No one is saying stuff should be free - you pay for the services through premiums, right? And when services aren't covered or folks don't have health insurance, who do you think ends up paying more in the long run? Yep, EVERYONE. So ...
Sunrocket October 27, 2012 at 10:03 PM
While my plan does pay for the mammogram and year check up - which this past year was around $500 I also pay an outrages premium with a huge deductible. I consider my insurance a entrance key to the Dr/Hospital - friends without insurance are charged upfront for services before they are rendered unless it is an emergency. That said, I get to go to my own Dr's of my choosing, get a discounted rate for other types of appointments. I'd rather stick with a plan of my choosing then run the risk of being told when where and how I do something. You don't get nothing for free - there is always a price.
Jay Sykes October 27, 2012 at 10:19 PM
My headline may be factually incorrect. We don't know exactly how much an individual mammogram cost in the pre or post Obamacare world. The cost could have gone up!
Randy1949 October 27, 2012 at 10:37 PM
Right, Heather. Which patient do you think costs the insurance company (and by extension, the people who pay premiums) the most -- a woman who gets a $400 mammogram every year or a woman who undergoes mastectomy, radiation and chemotherapy and spends weeks in the hospital?
Bewildered October 27, 2012 at 10:47 PM
Aren't you ladies supposed to moderate not participated? Pls keep your comments to each other on your Patch internal email, not on the blogs you oversee. Inappropriate at the very least. Guess any Patch claim of being unbiased is out the window now
3393 October 28, 2012 at 03:04 AM
Excellent points Mr. Hoffa.
Steve Ebbie October 28, 2012 at 08:18 PM
One has to wonder why anyone would think that making this diagnostic procedure more affordable can be anything but good. If you follow facts... insurance companies are now required to spend 80 percent of premiums collected on patient care. There is where the money comes from. If they do not spend it on care, they must provide a refund. If you know other facts... finding an illness in later stages will cost much more to treat. Insurance companies are "for profit" and in that regard patients are merely numbers and potential losses. This law protects the consumer which normally everyone would get behind. http://www.csgmidwest.org/policyresearch/jan11medicallossratio.aspx


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