Important Information About 3-D Mammograms
New technology is allowing doctors to perform a preventive procedure called a 3-D mammogram. Also known as tomosynthesis, this new procedure is not yet covered under many health plans.
Under the Affordable Care Act (ACA), non-grandfathered benefit plans are required to cover women’s preventive services, including standard mammograms. Since a standard mammogram must be covered with no cost sharing, many patients assume that 3-D mammograms will be fully covered as well, but this is not the case. Unfortunately, many patients have been learning too late that 3-D mammograms are not covered under their plan. This leads to out-of-pocket expenses that patients don’t anticipate.
It’s important for employers to understand what 3-D mammograms are, and what you can do to help your employees get the coverage they need for good health—without excessive out-of-pocket costs.
What is a 3-D mammogram?
Similar to a CT scan, a 3-D mammogram provides a three-dimensional image of the breast by taking multiple X-rays at different angles. This image is then reviewed by a physician for signs of cancer. However, this new technology is more expensive to perform than a standard mammogram.
You can add 3-D mammogram coverage to your plan
Since 3-D mammograms are a new medical procedure, many employees are seeking this service; however, most group health plans do not currently cover 3-D mammograms.
If you are interested in adding 3-D mammograms as a covered service under your plan, you can work with your Meritain Health client relationship manager to make this adjustment at your plan renewal. This way, you can help your employees take control of their wellness while saving on the cost of their preventive care.
If you have questions or need more information, simply contact your Meritain Health representative or client relationship manager.
This material is being provided as an informational tool. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this material and any attachments, Meritain Health is not exercising discretionary authority over the plan and is not assuming a plan fiduciary role, nor is Meritain Health providing legal advice.