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Paying for Cancer Screening and Prevention

Locate medical experts and find information on insurance coverage and financial assistance for risk management, treatment and follow up care.

Paying for risk-reducing mastectomy

Most insurance companies will cover the cost of risk-reducing mastectomy for women with a BRCA1, BRCA2 or other inherited mutation linked to increased breast cancer risk.  This surgery can be expensive; some women may face high deductibles or co-payments. Unfortunately, some companies still consider prophylactic mastectomy to be medically unnecessary, and they routinely deny such requests, even for women with high hereditary risk for developing the disease. Denials may occur when a woman decides to remove both healthy breasts to reduce her breast cancer risk, or when a woman who is having unilateral mastectomy to treat breast cancer wants to also remove her opposite healthy breast. If your request for prophylactic mastectomy with or without reconstruction is denied, ask your primary care physician, oncologist, and medical geneticist to write supportive letters explaining your high-risk status. If your insurance company denies these services, visit our health insurance appeals page for information on insurance appeals. 

Most hospitals have social workers or financial assistance counselors who can help explain your options and direct you to resources which provide assistance in paying for medical care. Some hospitals designated as Hill-Burton facilities receive money from the federal government. These hospitals must provide a certain amount of free or reduced-cost health services every year to those who cannot pay. Each facility may decide which type of free or reduced-cost care it will provide, and must publish this information in the newspaper, as well as provide a written notice to you upon request for Hill-Burton assistance.

Federally qualified health centers (also called “Community Health Centers”) can be a resource to anyone who needs financial assistance with their healthcare journey. Their mission is to provide care regardless of ability to pay. They often are the most knowledgeable about which other providers and organizations in their local community offer services at discounts, sliding fee scales, etc.  Their main focus is providing prevention services such as screenings.

All of the centers must provide access to mental health services and many provide access to general living assistance programs (energy assistance, child care assistance, housing assistance, etc.) 

Updated 11/05/15

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