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Health Care Reform:

Health Insurance & Affordable Care Act

Free Breast Cancer Screening & Prevention

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.

Free Chemoprevention Counseling

You may be able to take medicines to lower your risk for breast cancer. These drugs block the effects of the hormone estrogen, which can cause breast cancer to grow. This approach is called chemoprevention.

If you're at high risk for breast cancer, you can get free counseling to discuss whether you might need chemoprevention.

NOTE: Only the counseling is free. If you need the treatment, you'll have to pay for the medicines and associated doctor appointments. What you pay depends on your health plan's deductible and copay or coinsurance amounts.

Counseling to Help Lower Risks for Breast Cancer

You also can get free preventive counseling to help you manage other breast cancer risk factors. These include obesity, alcohol abuse, and poor diet.

Rules for Health Plans

Private health plans. Health plans must offer breast cancer screening coverage without requiring you to pay a copay or a deductible at the time of your visit.

Health plans in place before March 23, 2010, that have not substantially changed are grandfathered. This means that they're exempt from this requirement of the law. They can still require you to pay a copay or deductible for breast cancer prevention care.

If you're not sure if your health plan is grandfathered, you can call your insurance company, your state insurance department, or ask your HR department if you enroll in health insurance through work.

Medicare. Medicare pays the full cost of breast cancer screening tests and prevention.

Medicaid. If you gain access to Medicaid coverage as part of the program’s expansion under the Affordable Care Act, you might get breast cancer prevention services with no copay or deductible.

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