Insurance to Cover 3D Mammograms in Missouri

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SPRINGFIELD, Mo. — Your health insurance will now cover 3D mammograms starting this month. The technology was approved by the FDA in 2011 and has been an option for patients, but not required to be covered by insurance. 

Medicare and Medicaid cover 3D mammograms right now. And starting in August, all other insurance plans, including those through the ACA, will have to cover it, too. 

“I think a lot of women have been waiting many years for that to happen,” said Kelly Heard the clinical supervisor at CoxHealth Breast Care Clinic. 

Heard says 130 patients are seen for exams there every day, including mammograms, ultrasounds, and biopsies. She says patients have the choice between the standard 2D or the 3D imaging for their mammography, and that about 30 percent of patients are not choosing 3D.

“I can’t necessarily say it’s always due to the cost, but it does play a large role,” she said. 

But starting Aug. 28, all insurers in Missouri will be required to cover 3D mammograms if that’s what patients want. 

“This just was common sense,” said Rep. Dean Plocher, who sponsored legislation that made this possible. “Preventative medicine is the way to go.”

The legislation passed in Missouri in 2018. 

Rep. Plocher hopes this will impact the workplace in a  positive way and result in fewer false positives.

 “So, you take a worker out of the workforce less if they don’t have to go get a biopsy if there was a false positive,” he said. “And there’s also an emotional component to this, too. Fewer false positives means you don’t scare someone while they have to go home and sleep at night before they get further testing.” 

Heard says the 3D images can reduce the chances of a call back by 40 percent. 

“The exam is very similar to the 2D as far as the positioning. There’s still breast compression involved, however, they have included a little bit of a flex with that 3-d paddle to where it comes down and it doesn’t compress quite as hard,” she said. 

The 2D takes four images, and although it works, Heard says the 3D takes multiple images – one per millimeter of breast tissue –  resulting in finer details and improved visibility. 

“So, a CAT scan takes sliced images through the body, this is the same concept,” she said. “To be able to take that sliced out and look at it individually without having anything else superimposed over top of it.” 

Heard says medical professionals are hoping what, for now, is an option, will become the standard. 

This officially goes into effect on August 28. Insurance will pay the 2D rate until the end of the year. If the 3D costs more then the patient will have to pay the difference. 

But starting in January of 2019, when new insurance plans kick in, then the full cost of those 3D mammograms will be covered. 

Copyright 2019 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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