Our benefit covers screening mammograms based on your doctor’s recommendations. You do not have to pay if you receive a screening mammogram in-network. To learn more about evidence-based recommendations from the U.S. Preventive Services Task Force and coverage for preventive services required by the Affordable Care Act, visit uspreventiveservicestaskforce.org.
Diagnostic mammograms are also covered under the plan. The in-network benefit on a PPO is covered at no charge to the member. The in-network benefit on the CDHP/HSA is covered with applicable deductible and coinsurance. Out-of-network diagnostic mammograms are covered with applicable out-of-network deductible and coinsurance on all plans.
Providers determine which type of testing (screening or diagnostic) is appropriate based on factors such as a patient’s history, other tests and current symptoms and complaints.