Breast Cancer Susceptibility testing Under the ACA

mamogramThe Departments of Treasury, Labor and HHS released clarification on preventive care requirements under the Affordable Care Act. Specifically they addressed personal history as it relates to routine breast cancer susceptibility gene (BRCA) testing.

We should see all of the health insurance policies that are ACA compliant cover this type of test as preventive care. There are some stipulations that one must meet to have this covered at no cost to you.

A women will have to be over 18 years of age and have personal history of breast or ovarian cancer.

In the past, most carriers covered the testing if there was a family history of breast or ovarian cancer.

The higher end health insurance companies, should continue to cover the testing based on family history. The smaller companies may choose to use the government version for preventive coverage.

It doesn’t make sense, to determine the coverage as preventive, only if you have a personal history. The entire point of preventive care is to prevent the disease, not wait until you get it and then cover the preventive.

It’s very frustrating for us to learn that government agencies did not put much thought into the words they use to clarify an already complicated law.


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