By Kate Madden Yee, AuntMinnie.com staff writer

March 15, 2019 -- U.S. women who have a suspicious finding from a screening mammogram are delaying -- or even skipping altogether -- needed diagnostic exams because of high out-of-pocket costs, according to a study by the Susan G. Komen breast cancer organization.

Although the Patient Protection and Affordable Care Act (ACA) of 2010 made access to free screening mammography an essential health benefit, women who need follow-up diagnostic exams can face thousands of dollars in out-of-pocket costs, even before treatment, the organization found.

The study was conducted for Komen by the Martec Group. It included more than 30 interviews with healthcare providers and women who have been affected by the cost and lack of insurance coverage of breast diagnostics, Susan G. Komen said.

Researchers found that the average out-of-pocket cost of a diagnostic mammogram is $234, while a breast MRI can cost patients $1,021. These tests can be particularly burdensome for women who have been diagnosed with breast cancer and must undergo repeated follow-up exams.

The study also showed the following:

  • Women may be unsure of what variations in coverage and cost to expect, which can lead them to avoid follow-up while their cancers progress -- resulting in fewer treatment options and lower chances of survival.
  • Unexpected costs cause many women to cancel or delay recommended diagnostic tests.

"One of the key victories of the Affordable Care Act was the inclusion of no-cost cancer screenings, so more women could get breast cancers detected earlier," said Victoria Wolodzko, senior vice president of mission, in a statement released by Susan G. Komen. "Yet screening is only part of the equation. It does women little good to know they have something suspicious if they can't afford the tests that will actually detect their cancer."


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