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Health Care Reform:

Health Insurance & Affordable Care Act

Free Breast Cancer Screening & Prevention

Breast cancer screening  can save lives. That's why the Affordable Care Act makes breast cancer screening and counseling free. All health plans must cover these benefits at no cost to you.

More than 40,000 women die from breast cancer every year. It's the second leading cause of women's death from cancer.

But if you find breast cancer at an early stage, you have a 98% chance of surviving. That's the point of mammograms -- they are screening tests that help find cancer when it is too small to feel.

Your odds of long-term survival drop to 25% if your doctor finds your breast cancer late, when it has spread outside your breast. So it's worth your time to take advantage of these breast-cancer-prevention measures that are free under the Affordable Care Act.

When Are Mammograms Free?

You can get a free mammogram every 1 to 2 years if you're over 40.

Can I make an appointment for just the free screening?

You can schedule a breast cancer screening by itself or as part of your annual checkup or OB/GYN appointment.

Can anyone get a free mammogram at any time?

You have to follow the guidelines.  You have to be over 40. You're only covered for a mammogram every 1 to 2 years -- the specifics depend on your policy, as outlined in its summary of benefits.

NOTE: Mammograms are only free as a screening for women without symptoms. If you go to the doctor with a symptom -- like a lump -- the mammogram is considered a "diagnostic test." In that case, you'll need to pay any deductibles and a copay or coinsurance, just as you would for other tests your doctor might use to rule out problems.

Are follow-up tests and biopsies free, too?

No. Again, if you have symptoms, follow-up mammograms and biopsies are not screening tests. They are diagnostic tests and not part of the free screening. 

If the mammogram shows I have cancer, is my treatment free?

No. If your screening shows that you do have cancer, you will be required to cover the cost of copays or coinsurance and deductibles for treatment as your plan guidelines dictate.

If you are enrolled in Medicaid, though, all states extend benefits to women whose breast cancer is found under the National Breast and Cervical Cancer Early Detection Program.

At High Risk? Check on BRCA Counseling

If people in your family have had breast cancer, you may get free genetic counseling. Doctors will ask questions about your family's medical history.

Based on your answers, they might do a test at no cost to see if you have certain genes. That test looks for what's called a mutation in your BRCA1 or BRCA2 genes. These genetic changes make you more likely to get breast and ovarian cancer.

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