DWQA QuestionsCategory: Women's HealthI am 35 and I have a family history of breast cancer. What services are covered?
HealthTNHealthTN Staff asked 4 years ago

I am 35 and I have a family history of breast cancer. What services are covered?

1 Answers
HealthTNHealthTN Staff answered 4 years ago

If you are considered to have a family history that makes you at high risk for certain genetic mutations that are associated with increased risk of breast cancer (BRCA1 and BRCA2) and are enrolled a non-grandfathered plan, then your insurance should pay for the both the counseling and the genetic testing without charging you cost-sharing.

Screening mammography is included as a recommended preventive service that will be available to women in private plans. The coverage rule is based on the U.S. Preventive Services Task Force Recommendation from 2002 that recommends screening mammography every one to two years for women age 40 years and older. Since you are under age 40, federal rules do not require your plan to cover the costs of the screening mammogram without cost sharing, so you may have to pay out-of-pocket for some or all of the costs of that screening mammogram.

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