How do I pay for a mammogram or chest wall exam?
Payment for services depends on health insurance coverage. The Affordable Care Act requires insurers to cover the cost of breast tissue screenings for any patient who is at least 40 years old and any patient under 40 who has been referred by a primary care physician due to a family history of breast cancer or other risk factors.
What is health insurance?
Health insurance is a system of payment that helps pay for medical costs. Insurance plans vary, with some covering a wide array of services including mental health care and some covering only a few services like preventative care. Some insurance plans leave no out-of-pocket costs, some have co-pays, and some may cover only a percentage of medical costs requiring the patient to pay the rest.
There are two main types of insurance: public and private.
What is public health insurance?
Public insurance options are those funded not by a company but by the state and federal governments. These include programs like Medicaid, Medicare, and CHIP.
You may be eligible for one of these public insurance options if:
- Your household income is less than 138% of the Federal Poverty
- You are over the age of 65
- You are under the age of 19 and your household income is below 200% of the Federal Poverty Level
- You are a member of a “medically needy” group which encompasses those with disabilities.
What about private health insurance?
Private health insurance plans are all the health insurance plans that are not public. Sometimes people get private health insurance through their employer. Private health insurance plans can also be bought directly from insurance companies or found on the Health Insurance Marketplace.
- If you have insurance, you can confirm that your insurance covers the cost of mammograms and chest wall exams by calling the phone number located on your insurance card. You can also find out if your insurer covers the cost of the new 3-D mammogram technology or if they only cover 2-D technology.
- If for any reason you do not have health insurance coverage, you may get mammography and chest exam care at some community clinics and hospitals, which provide free or sliding-scale payment for services based on your income.
How do I apply for health insurance?
- Apply online: Visit https://www.healthcare.gov/get-coverage/
- Apply by phone: Call 1-800-318-2596
- Apply in person: Visit your local Job and Family Services office.
- Apply online: Visit https://benefits.ohio.gov/
- Apply by phone: Call 1-800-324-8680
Medicare takes place through the social security office. You can find out more about enrollment in one of the following ways: