One of many letters I sent out last week.
Dear Senator Gillibrand,
I am a 49 year-old woman with dense breast tissue and my mammogram results are always “abnormal.” Therefore, after each free Mammogram, I must have a sonogram or an ultrasound.
As of 2015 that ultrasound which helps determine if I have breast cancer or not, according to Aetna, is now considered a diagnostic test and is no longer covered in the cost of my free Breast Exam but rather is applied to my deductible. My free breast exam cost me $140. EVEN THOUGH MY MAMMOGRAM IS ABNORMAL!?
Making this essential testing “diagnostic” rather than preventative is both misogynistic and immoral. I believe this particular policy shift seems to be linked to the, alas, (un)affordable care act – which I supported – and still do. However, I have learned that in addition to Aetna, Oxford doesn’t cover the ultrasound for women with dense breast tissue. For many families, this makes getting adequate and accurate test results inaccessible! So much for early detection of Breast Cancer!
My young cousin, mother of two, recently informed me that her breast cancer was not detected by mammogram but rather was discovered through a sonogram.
“Only after asking her doctors why the mammogram did not find her cancer was she told that she had dense breast tissue—and that mammograms have a hard time spotting tumors in such breasts. She did some digging in the scientific research, and discovered that has been a huge issue for decades. Seventy-four percent of patients between 40 and 49 years old have dense breasts, according to one study.”
Ironic twist that the woman at the collection agency (I have been fighting this decision for so long that my bill finally went to collections – and today I finally gave up) should have dense breast tissue and was horrified to hear that her ultrasound might not be covered. This isn’t so surprising as nearly half of women have dense breast tissue.
The Aetna representative I spoke with asked me if there was anything else she could do for me once she informed me that all of my appeals were denied. I told her, “Yes, you may pray that I do not get Breast Cancer. If I do, not only will it be terrifying for me and my husband and children, but it’s going to cost Aetna a great deal more than this ultrasound.”
“…for women with dense breast tissue it is critically important to supplement a mammogram with another screening tool —such as an ultrasound. “When women with dense breasts supplement their yearly mammogram with an ultrasound, the combined screenings detect cancer 97 percent of the time,” says Cappello.”
If there were such a thing as dense testicle tissue would the sonogram be free and considered a “preventative” procedure?
I voted for you.
P.S. My mother died of pancreatic cancer at 60