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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 breast cancer screening

National expert guidelines recommend women at high risk for breast cancer undergo the following surveillance on an annual basis beginning at age 25:

  • breast MRI
  • mammogram (some health care providers recommend waiting until 30 for mammograms)
  • clinical breast exam 

Most insurance companies will cover the cost of these tests for women with a BRCA1, BRCA2 or other inherited mutation linked to increased breast cancer risk. If your insurance company denies these services, visit our Health Insurance Appeals page for information on insurance appeals. 

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.) 

Breast MRI
Although most insurance companies will cover the costs for breast MRI, this screening can be expensive; some women may face high deductibles or co-payments. Your health care provider can help you write an appeal letter if your insurance will not cover screening MRIPatient Services Incorporated is a national nonprofit organization that has an MRI co-pay assistance program for high-risk women. The program pays for women who are 45 years of age or younger with a family history of breast cancer or who have tested positive for a BRCA mutation. 

Mammogram
The Affordable Care Act requires insurance companies to pay for mammograms with no out-of-pocket expenses for women ages 40 and older. However, the law does not apply to women below age 40, and it covers, at most, one test per year. Most insurance companies will cover the cost of mammograms for high-risk women below age 40 as recommended by national guidelines. Some out-of-pocket cost may be required. 

CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides access to breast cancer screening services to underserved women ages 40 and above in all 50 states, the District of Columbia, 5 U.S. territories, and 12 tribes.

Breast cancer screening within research
There are early detection breast cancer research studies that may cover the cost of screening within the study. Visit our HBOC research search tool to find prevention and detetion research studies. 

Updated 12/23/16

FORCE:Facing Our Risk of Cancer Empowered