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Health Care Reform:

Health Insurance & Affordable Care Act

Cancer Screening and Prevention Under Health Reform

Your chances of surviving cancer are much better when you find it early. That's why the Affordable Care Act makes it possible for you to have free cancer screening tests.

Cancer screening tests are a type of preventive medical service. They are included as part of the essential health benefits that must be covered by any health plan you can enroll in on your state's health insurance Marketplace. In fact, plans must offer certain free cancer screening tests if they want to be part of the Marketplace.

Free Cancer Screening Tests

Experts have learned over time that screening tests for certain types of cancer can save lives. Here's what you need to know about screenings for some common cancers.

Breast cancer. Mammograms to find cancer early are just one part of preventive care women can get without having to pay a copay or coinsurance. 

Cervical cancer. Cervical cancer is rare among women in the United States. That's thanks to regular Pap tests and tests for HPV, the human papillomavirus, which can lead to cervical cancer.

The Affordable Care Act requires that private health plans provide Pap tests and cervical cancer screening without asking women to pay a copay or coinsurance. Women older than 30 may have HPV testing every 3 years, regardless of Pap smear results.

The exception is private health plans that were in place before the law was passed in March 2010. These "grandfathered plans" don't have to offer the tests at no cost to you. Some of them may do it anyway, though. Check your plan's summary of benefits or call your health plan if you aren't sure if your plan is grandfathered. 

If you have Medicare, you won't be charged for Pap tests and pelvic exams. Medicaid also covers Pap tests, but the details vary from state to state.

Colon cancer. Nine out of 10 people survive long-term if their colon cancer is caught early. However, just 40% of colorectal cancers are found at that early stage. If the cancer spreads to nearby organs or lymph nodes, the 5-year survival rate goes down to 70%. If it spreads to distant organs, your survival rate drops to 12%.

Under the Affordable Care Act, private health plans must offer one of several different types of screening tests for colon cancer. After age 50, you can receive a fecal blood test, a sigmoidoscopy, or a colonoscopy without owing a copay or coinsurance. Again, this does not apply to grandfathered plans -- be sure to check your plan's summary of benefits.

Medicare coverage also offers free colon cancer screening tests. It's possible, though, that you might have to pay copay for the doctor’s visit, anesthesia, or hospital visit.

What Medicaid will cover depends on which state you live in.

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