Mammography is a specific type of imaging that uses a low-dose X-ray system for examination of the breasts. It allows a radiologist to identify differences between a normal breast and one that may show signs of cancer. A mammogram is the best available method to detect breast cancer in its earliest stage, which is approximately one to three years before a woman can feel a lump.
WHAT TO EXPECT
During a mammogram, you can expect the following:
- You will be required to undress above the waist. The facility will provide a wrap for you to wear.
- A technologist will be present to position your breasts for the mammogram. You and the technologist will be the only persons present during the mammogram. Most technologists are women.
- The entire procedure takes about 20 minutes. The actual breast compression only lasts a few seconds.
- You may feel some discomfort when your breasts are compressed, but you should not feel pain.
WHEN TO GET ONE
Women in their 20s and 30s should have a clinical breast examination as part of a periodic health exam by a medical professional every three years. After age 40, women should have a breast exam by a health professional every year. The U.S. Preventative Services Task Force recommends that women ages 50 to 74 should get a mammogram every two years.
The risk of getting breast cancer increases with age, so as long as a woman is in good health, she should continue getting routine mammograms. Young women at high risk for breast cancer should discuss with their doctors if earlier screenings are necessary.
QUESTIONS TO ASK
The following are suggestions for ensuring you will receive a quality mammogram:
- Ask to see the FDA certificate issued to all facilities that meet high professional standards of safety and quality.
- Use a facility that either specializes in mammography or performs mammograms often.
- Bring a list of the places, dates of mammograms, biopsies, or other breast treatments you may have had before.
BREAST CANCER SCREENINGS & YOUR TSHBP BENEFITS
- Is a Mammogram Covered under my TSHBP Benefits? Yes, routine mammograms for women ages 35 and older are part of your plan’s Preventive and Wellness Services for Adults in compliance with the Affordable Care Act (ACA).
- What is my cost for a mammogram under my TSHBP Benefits? As a preventative care service, your mammogram will be covered by your plan at 100%.
- What do I do if I need a mammogram?
| FREE-STANDING RADIOLOGY CENTER OR DOCTOR’S OFFICE | HOSPITAL | |
| STEP 1 | (855)-830-9234 Call us to confirm your provider is part of the Health Smart Physician and Ancillary Network. If you need a provider, we’ll find one for you. Our Provider Search Tool is also available to you! | (888) 803-0081 Contact the Care Coordinator to coordinate facility services. |
| STEP 2 | Call your doctor to schedule an appointment. Provide the office staff with your insurance information, including the provider network Health Smart Physician and Ancillary Network. | Your Care Coordinator schedules your procedure with the provider and facility and arranges the payment. The Care Coordinator provides you detail instructions on what to expect when you go into the facility. |
| STEP 3 | Present your TSHBP member insurance card at your appointment. | No ID card or paperwork needed. You go to the facility and have your procedure as scheduled. |
Download an infographic of the chart and other helpful information below. If you have any questions about your TSHBP coverage, please contact us to speak to a representative. 