Health plan details — often containing critical information about one’s coverage — are still being overlooked, or not looked at all, by many consumers. This fact jumped out starkly in new research about women and breast cancer screening coverage.
In data based on input from 1,500 adult women with health insurance, nonprofit Bright Pink found far too many women in the study group thought they had robust screening coverage when they didn’t actually have it.
The research was conducted in part to determine whether most women’s plans included coverage of the cost of breast tomosynthesis (3D mammography exams), a screening highly recommended for women by the National Comprehensive Cancer Network.
While 86 percent of the women agree the latest screenings for breast cancer should be included in their plan, and most benefits managers thought their plans did include such coverage, about 20 percent of the benefits managers in the study incorrectly assumed their plans covered 3D mammography. About 3 in 10 didn’t know if 3D mammograms are covered by their company’s plan.
In fact, Bright Pink says. the only national plans that cover 3D mammography exams are those offered by Cigna. “This means that the majority of working women are enrolled in health plans that don’t cover 3D mammography exams for breast cancer screening,” Bright Pink said.
“We all want to believe that we have great insurance coverage, but unfortunately plans rarely boast about what they don’t cover,” says Sarah Storey, president of Bright Pink. “Employee benefits managers should ask their insurance plan if they cover 3D mammography exams for breast cancer screening rather than just assume they’re covered — and if they are covered, they should let the women on their plan know.”
Bright Pink notes that nearly half of women who have a mammogram are called back for a second one. Because 3D mammogram exams reduce unnecessary call-back exams by 15 percent, the nonprofit said plan managers and consumers should work together to ensure that the exam is covered by a woman’s plan.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
