They were ordered to receive special breast cancer screening. Then they are stuck with the bill.

When Mully Smith went to her first mammogram in 2021, she had a reason to be careful. Another mother, mother, sister and family member, have been diagnosed with breast cancer.

Mammogram detects unusual tissues – Smith, 46 years old, the mother of two people from Mire Telescar Carolina – and more need to test. To relieve her great suffering, Smith has been cleaned after the ultrasound, MRI and meat examination. But she costs more than $ 1,000, her insurance is not comprehensive.

Smith is one of millions of American women who are at high risk of breast cancer. But the insurance does not cover the cost of screening that is needed to detect the disease. Breast cancer can be hidden in mammogram for many women. Therefore, doctors recommend additional screening, including ultrasound, mrisynthesis. Which is a 3D mammogram

“With ultrasound, you will find cancer that does not appear in the mammogram,” said Dr.. Madhavi RAGHUSpecialist in tumors in the connection. “If the synthesis tomosynthesis It is normal and ultrasound is normal. The chances of patients have cancer are quite low. “

A woman with dense breast tissue, which is a condition that affects approximately half of women, more than 40 people are at a special risk for breast cancer as the Food and Drug Administration said. Conditions make it more difficult to find cancer on mammogram. Therefore, last year FDA starts Mammogram service providers to inform women with dense breast tissues that they may need assessment and screening to distinguish cancer.

But the screening has money from the pocket for most women. While one year mammogram is often covered by private health insurance plans But in general, they will not fully refund the money for additional screening.

And last year, doctors in Connecticrat Niu York, Carolina and Texas said that the Mediler stopped repayment for the same breast cancer ultrasound. Returned in 2023, RAGHU gave NBC news. The screening of the breast is refunded in the year 2023.

Lack of coverage makes women have Medicare and those who have a scary private insurance.

“You know that you have to go back,” Smith said, which has private insurance, “and there are always questions that appear: I am a time bomb and what will it cost?”

The female spokesman of the Medicare and Medicaid Services center said in a statement that the ultrasound or MRI was protected by Medicare when receiving a diagnosis test.

“If the scan is arranged as a test of the screening of Medicare, it cannot be comprehensive,” she said.

The screening is considered a regular testing model for patients without symptoms, while the diagnosis tests examine the symptoms or disorders found during the screening of the female spokesman of CMS. The agency has not changed.

Ultrasound screening for women with dense breast tissues under the interpretation of CMS will not check the symptoms. The doctor questioned this explanation because there was only one payment code for ultrasound, whether the screening or diagnosis test. The latest denial by Medicare seems to place all the ultrasound in the category that is not comprehensive.

The doctor said that there is another problem with Medicare that does not pay back for ultrasound and other screening: private insurance companies tend to be the leader of the CMS to decide to pay back.

Restrictions for cancer screening means higher external costs for women who want them. The cost that has not been increased has been increased. Research that is published in the journal radiology showsWhen women are registered for insurance plans that can be highly reduced to reduce health care costs. The study also confirms the fear that many doctors show: must face additional costs for the necessary screening. Many women do not receive. About 21% women who survey the study of the radiology, say they will refuse to screen more if they have to pay them.

“The fact that Mammogram is not a good standard or an indicator is a problem that we must raise awareness.” Fish South Dagota said Because breast cancer often does not appear in the Caldwell mammogram, so there are MRIS every year. This year, she said that she expected to pay $ 1,200 from the bag.

“Feel that you should not struggle to receive a special screening you need for detection first,” Caldwell added. “Previously, you can catch a cheaper cancer to treat. This should be easy. “

Increasing urgency: The latest statistics of the American Cancer Association Regarding breast cancer, it was found that between 2012-2011, the diagnosis increased faster among women less than 50 years old than women older than 50 years.

LISA LACASSE, the president of the American Cancer Association, said Action Network, “deleting the cost sharing for each intervention in the screening process is an important step in the end of the cancer as we know for everyone.”

last year Iowa’s legislative legislative legislation Want private health insurance companies to cover all the costs of breast cancer, such as ultrasound and MRIS, while Massachusetts law From the past autumn, there must be an insurer to cover ultrasound and other screening without increasing the cost of patients.

Legislative Assembly in Connectic Chatvilla Indee, Hawaii, Hawaii, South Carolina and Virginia have just launched the bills that want the insurance company to cover these additional screening. American College of Radiology– The American Cancer Association says that they hope to see similar laws passing through the Nebraka Pennsylvania, Rodieland and Wiscon Sin.

Other states such as Southada Kota and Montena have tried to pass a similar law. The latest effort in Montana failed. Chetley, the teacher, and the survivors of breast cancer in BigFork, Montana. She needs a normal MORIS to detect the return of her cancer. The cost of special screening is around $ 3,500 each year, she said that the cost of the high -deduction of her employer is not comprehensive.

“I just knew that there were other women there were not screening because of the cost,” EMSLIE said to NBC News. “You will have people with mammogram and need more screening. But they will not go back. ”