Will new mammogram guidelines change health insurance coverage?

The U.S. Preventive Services Task Force has decided that mammograms aren’t all that preventive, especially for women under 50. Under new guidelines issued earlier this week, the task force said that mammograms needn’t be recommended for women ages 40 to 49 who are not high risk (i.e. having a history of breast cancer in their families). Annual mammograms are no longer recommended for average-risk women age 50 to 74, but now instead are recommended every two years.

That said, a woman who wishes to get annual screenings should do so, but the task force says that routine annual screenings are not necessary.

What does this mean for your health insurance coverage? We shouldn’t worry that health plans will start dropping or denying coverage for mammograms. If you visit your doctor and get a referral for a mammogram, it will be covered (assuming your plan covers preventive tests in the first place).

In addition, all 50 states mandate that group health insurance plans cover mammography. These mandates are unlikely to be dropped, which would require state legislative action.

To see what’s mandated where you live, see “health insurance mandates in the states 2009” from the Council for Affordable Health Insurance.