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 (USPSTF) and coverage for preventive services required by the Affordable Care Act, visit uspreventiveservicestaskforce.org.
Diagnostic mammograms are also covered under the plan. As with other non-preventive x-rays, labs and diagnostics including reading and interpretation (not including advanced x-rays, scans and imaging), the in-network benefit on the PPO plans is a coinsurance percentage without first meeting your deductible. The in-network benefit on the CDHP/HSA is covered with applicable coinsurance
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.