Why are some women are paying more for mammograms?

Why some women are paying more for mammograms

When the time comes for imaging for breast cancer prevention, some women are getting slapped with a big bill, and copays of up to $1,000.

HOUSTON - Groups of women are fighting what they call unfair and dangerous laws regarding breast cancer detection. Here’s the issue, by law, insurance companies cover a "screening mammogram" but when women need secondary imaging, some ladies are getting hit with a big bill.

"The Affordable Care Act made it where all insurance covers the screening mammogram but not necessarily the diagnostic mammogram," explains Julie Voss the Executive Director of Susan G. Komen Houston. In other words, if the initial mammogram detects something unusual and follow up cancer-detecting imaging is ordered some insurance requires a co-pay of up to $1,000.

"What we found is women just didn’t go get that secondary mammogram. Then by the time they were able to get that mammogram the cancer was already more advanced," Voss explains.

"No matter what I had to sacrifice, if it meant cutting back on groceries or something, whatever it took I was going to get the follow mammogram," adds Makieba Hatton. 

When Hatton was told she had to pay an expensive co-pay to get a Diagnostic Mammogram she unsuccessfully appealed to her insurance company to waive the fee. 

"Thank goodness they were able to break it into parts for me. So I paid half upfront," says Hatton.

With hundreds of others, Hatton and Voss fought for the last three Texas legislative sessions to get the state law changed.  Thanks to their persistence House Bill 170 was passed.

"It will go into effect with your insurance company when you renew January 1, 2020 and ensures that any state-regulated insurance covers diagnostic mammograms," Voss explains.

It's a law not many states have. 

"It’s a huge victory for women," says Voss who is now working with women across the country for a nationwide win, trying to get federal legislation passed.

By the way, Makieba Hatton is grateful she didn't put off getting the expensive diagnostic mammogram.  She was diagnosed with breast cancer and has been free of the disease for a year now.