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Coverage of screening and prevention can be complicated

MammogramFor people at an increased risk of cancer, there are a number of recommendations and options to reduce the risk of cancer or to catch it early, when it is more easily treated. A majority of health plans cover certain cancer screenings and medications that reduce risk at 100%, with no cost to you. Although they are "preventive," other cancer screenings, as well as risk-reducing surgeries, may be covered by your health plan but deductibles, coinsurance and copays apply. Insurance coverage is variable based on many factors, including:

  • the specific screening, medication or treatment,
  • your age,
  • your gender,
  • type of insurance, and
  • health plan specifics such as benefits, exclusions, deductibles, coinsurance and copay amounts.

In this section, we explain the differences in coverage under private versus public health insurance plans and what is required by the Affordable Care Act. We also provide resources for financial assistance and guidance for insurance appeals.