Preventive Care May Be Free, but Follow-Up Diagnostic Tests Can Bring Big Bills
The Affordable Care Act ensures that preventive services such as breast cancer screenings are free, but patients who require follow-up testing ordered by a health care provider could face bills of hundreds or thousands of dollars for diagnostic services. Sixteen percent of mammogram screenings between 2010 and 2017 required follow-up imaging or other procedures, according to a study of 6 million commercial insurance claims, with half of the women who received a biopsy and additional imaging paying $152 or higher out of pocket in 2017 for those procedures. "The billing distinction between screening and diagnostic testing is a technical one," said A. Mark Fendrick, MD, director of the University of Michigan's Center for Value-Based Insurance Design. "The federal government should clarify that commercial plans and Medicare should fully cover all the required steps to diagnose cancer or another problem, not just the first screening test."
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