Health
Paying for High-Intensity Breast Exam to Detect Cancer – NBC 6 South Florida
More than 300,000 women are diagnosed with breast cancer each year. Last year, Rochelle Brodersinger was one of them.
She says her cancer would not have been discovered if she hadn't had an ultrasound, but many women face difficulties getting insurance.
“My doctor called me and told me I had breast cancer, so I actually had to ask him to repeat himself,” Brodersinger told NBC6.
Brodersinger was 49 years old when she was diagnosed with a common form of breast cancer last year. She credits diligent testing for early detection, but as a woman with dense breast tissue, a mammogram wasn't the only thing she needed.
“I just had a mammogram and the technician turned to me and said, 'You have very dense breasts. You'll also need an ultrasound. Always an ultrasound. ,” she said.
New rules from the FDA now allow women to be informed about their breast density. Dense tissue is a risk factor and can make it difficult for mammography to detect cancer.
“Now that women are learning more about their breast density and being told they have dense breasts, we hope it will encourage them to ask themselves questions about what this means and what they can do about it. ” Brodersinger said.
Many women ask who will pay for it.
Back in May, NBC6 has been vetted with many top medical insurance companies There was controversy as to whether breast ultrasound examinations were covered.
Fast forward to the FDA's new recommendations and we checked in again. Some health insurance companies did not respond. However, Aetna, Florida Blue and United Healthcare said they will also cover ultrasounds if a doctor deems them medically necessary. However, what is considered medically necessary is open to interpretation.
“I think that having that recommendation in writing will change insurance coverage,” said Dr. Carmen Calfa, a breast oncologist at the University of Miami Health System. They will respect that reason and follow the science that says ultrasound doubles the detection rate. ”
She's optimistic about the FDA's recommendations.
Currently, women under 40 or who wish to have further imaging tests as a precaution must pay for them.
“For years, I actually paid for my ultrasounds out of pocket rather than through insurance because, as a cash-paying patient, I had to pay copays and deductibles that I otherwise would have had to pay. 'I'll pay if it goes through my insurance because it was cheaper to pay in cash,' Brodersinger said.
She said ultrasounds helped her detect cancer early and talked about many things about cancer, including the importance of getting a second opinion, making a list of questions to ask your doctor, and that knowledge is power. He said he had learned the lesson.
NBC6 spoke to several diagnostic centers that said even if an ultrasound is covered for medical reasons, you may be forced to pay a deductible and co-pay. If you choose to pay out of pocket, be sure to ask, as it can cost anywhere from $150 to $400. In some cases, your out-of-pocket costs may be less than your deductible.
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