A story published by CBS News revealed that some insurance companies refuse to cover mammograms, even for breast cancer survivors. They first looked into this issue in October for their series, Medical Price Roulette. After they aired the story, hundreds of women called in and told their stories. They shared about how they could not afford the follow-up tests that their doctors had ordered, such as ultrasounds, MRIs, and additional mammograms.
A different battle for breast cancer survivors
One of the breast cancer survivors, Roseanne Neill, shared her battle with her insurance company for the past year, and unfortunately, she is losing. The 52-year-old single mother stated in her interview with CBS News correspondent Anna Werner that she felt that she was being penalized for having breast cancer.
Neill was diagnosed with cancer in 2015. Since then, she had annual diagnostic mammograms paid for by her insurance. Last year she changed jobs. In October, she went in for a mammogram and got a bill for over $900 about a month later. Her insurance company, Aetna, had refused to pay.
Neill recounted how her insurance company told her that they do not cover diagnostic mammograms. She tried to take a stance as a breast cancer survivor, but the bill was still not covered. The Affordable Care Act requires insurance companies to pay for regular screening mammograms for women with no extra costs. But because she is a breast cancer survivor, Neill said that her doctor advised her to take a diagnostic mammogram, which is a similar test that is read more quickly, every year for five years after her cancer treatment.
Neill appealed to Aetna, and she said that she told the company that she did not feel that it was fair to be penalized for having had breast cancer. She said she did not receive any response, so there was no negotiation and no further discussion.
In a letter, Aetna told Neill that her claim was processed correctly and that Aetna does not consider the test as a part of the standard routine testing.
Neill is just one of the hundreds of women who have shared their stories with CBS News. One woman wrote that she feels punished for being a survivor because of the costs. Another woman said that she skipped her mammogram this year because she can't afford to have it happen again.
Another cancer survivor, Kristen Hoffman, fought breast cancer last year, and now she is battling with her insurance company, Cigna, to pay for her mammograms. She said that she felt like getting the runaround, and sometimes she does not have the bandwidth to fight the battle.
Fighting for women's health
Molly Guthrie, a representative of Susan G. Komen Foundation, which is pushing lawmakers to get all breast cancer screening tests covered, said that this issue is creating a significant barrier to care. She said that they want the diagnostic testing that a physician feels their patient should have and that the patient can have access to that without paying. So far, the bills have passed in five states.
Debbie Dingell, a congresswoman and a co-sponsor of the federal legislation in the House, said that so far, there are no Senate sponsors. She said that they need to make sure that every woman has access to the tests that they need to know if she's got breast cancer.
CBS News called Aetna regarding Neill's bill, and they were informed that Aetna mistakenly did not apply the appropriate policy when Neill appealed.
The insurance company also said that they will reprocess Neill's claim and reimburse her for any additional costs. CBS News asked whether any other women are affected by mistake, but Aetna said that it was an isolated issue.
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