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Breast Cancer Screening: Your Legal Rights
Marion Galant, Colorado Department of Public Health and the Environment

Fortunately for Colorado women, coverage for screening mammography is required of group health insurers in most cases. Mammography, or low-dose x-rays of the breast, is a very important screening tool in the fight against breast cancer. Until this decade, coverage in group health plans was optional. A law passed by the Legislature in 1990, and amended in 1995, requires all group sickness and accident policies to provide coverage, with some exceptions. The mammograms are not even subject to policy deductibles, and they do not diminish or limit other diagnostic procedures provided by the policy.

According to Debora Judish of the Colorado Women’s Cancer Control Initiative in the Colorado Department of Public Health and Environment, "Colorado has recognized the life-saving potential of routine mammography, along with monthly self-exams and an annual clinical exam." The law, Colorado Revised Statute 10-16-104(4), requires coverage of $60 or actual cost, whichever is less, for a mammogram on a schedule that increases testing frequency with age. For low-income women over 50 who do not have health insurance and meet income eligibility requirements, the Colorado Women’s Cancer Control Initiative in the state health department can provide free mammography. (Contact them at 303-692-2600).

According to the law, group health insurance plans must cover a baseline mammogram between age 35-39; a mammogram every two years between 40-49, annually if a woman’s doctor has determined that she is at higher risk for breast cancer; and annually after she turns 50. The requirement to cover mammograms applies to new, renewed or reinstated policies after July 1, 1995. Insurers may require that a provider who is affiliated with their health plan render these mammograms. Companies that are self-insured aren’t covered by the law, though, which is a substantial number of businesses. Call your human resources office if you are not sure about your company, or check your contract.

"Mammograms can spot breast cancers when they are too small to see or feel. We can offer women life-saving treatment so much sooner if the cancer can be picked up early in a mammogram," Judish said.

Marion Galant is a public information officer at the Colorado Department of Public Health and the Environment and a volunteer public relations specialist for the Colorado Race for the Cure.Ô