Response to Inquires Regarding New Mammogram Recommendations:

The recommendations made by the US Preventive Services Task Force are very new. Our coverage has not changed. If you have questions about mammography testing and/or the frequency of mammography testing that is appropriate for you, we encourage you to speak with  your physician.

Coverage Information:

• Mammography is a covered benefit and is based on our guidelines.
• No referral is needed to schedule or receive a screening mammogram.
• Check applicable benefit document for more information (eg co-payment and/or deductibles).

Breast Cancer Screening and Prevention: 
18–39 Years of Age:

• Starting at age 20, perform clinical breast exam and provide self-exam instruction.
• Advise mammography for patients at high risk. Risk factors include: family history of premenopausal breast cancer (mother or sister) and personal history of breast/ovarian/endometrial cancer.

40-49 Years of Age:

• Perform clinical breast exam and provide self-exam instruction.
• Annual mammography at discretion of clinician/patient.

50-64 Years:

• Perform clinical breast exam and provide self-exam instruction.
• Annual mammography.

65+ Years of Age: