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Medication to lower cancer risk for certain womenWoman taking a pill with a glass of water

The Patient Protection and Affordable Care Act (ACA) requires most health insurance plans to pay for "chemoprevention counseling" and if appropriate, medications that reduce a woman's risk of cancer such as tamoxifen or raloxifene, or aromatase inhibitors. These medications must be covered at 100%, with no out-of-pocket costs for women ages 35 and older who meet the U.S. Preventive Services Task Force (USPSTF) guidelines. However, the law does not apply to women under the age of 35 and some high-risk women may not be eligible for 100% coverage.

Note that the ACA does not apply to Medicare or Medicaid. They have their own rules. See the Insurance & Paying for Care section of our website to learn more.

clinical-trials

  • Visit the FORCE Research Study Search tool for information on hereditary cancer prevention and early detection research studies.
paying-for-service

  • Problems with insurance coverage of medications or other recommended screening and preventive services? Visit our section on Insurance & Paying for Care for guidance.