August 28, 2017
Thousands of Vermonters follow their doctors’ advice and get an annual mammogram screening. About 10 percent the time, they will get called back for an additional views. Being told that you have to come back for more views can be stressful, but most of the time, it should not lead to additional cost for Vermonters.
In 2013, the Vermont Legislature passed a law requiring mammography, including call-back screening, to be covered without copayments or deductible charges. This means even if you are still in your deductible, your screening mammogram will be covered.
The Vermont Legislature wanted mammograms to be covered without cost sharing for a good reason. Early diagnosis of breast cancer is key to improving outcomes and saving money. It is hard enough for Vermonters to get timely screenings without worrying about how they will pay for them.
The law, however, has not been fully implemented. Women are paying hundreds of dollars for screenings that should be covered in full. Other women are avoiding mammography screens out of fear that they will be called back and have to pay. At the office of the Health Care Advocate (HCA), we hear stories of women being charged anywhere between $300 and $500 for screenings that should be covered at no cost.
The HCA is working with Vermont’s insurance companies and health care providers to implement the law and make sure that Vermonters are not charged for their screening mammograms in order to comply with the law.
The HCA takes our role in protecting Vermonters from inappropriate health care charges seriously. Last year our advocacy for individual Vermonters saved over $320,000 in medical or insurance charges.
If you have been called back for an additional mammography screen and were charged, we want to hear from you.
Contact the Office of the Health Care Advocate at 1-800-917-7787, email@example.com, or vtlawhelp.org/health, where we have an online help request form. Our office provides free help to all Vermonters who have questions about and problems with health insurance and health care.