Central Vermont Medical Center is committed to providing every woman her recommended mammograms. CVMC’s Patient Navigator works with women who have insurance or financial challenges to find the best way to get their mammograms paid for.
If You Have Health insurance
If you have health insurance, we will bill your insurance company:
- At Central Vermont Medical Center, we offer the latest technology of 3D/Tomosynthesis Breast Imaging. Our standard of care is to provide you with the most effective imaging; therefore we perform 3D/Tomosynthesis exams unless otherwise notified by the patient. Currently not all insurance companies are covering the full cost of 3D/Tomosynthesis imaging, which can leave you with an out-of-pocket charge of about $210.00. (Updated: June 2019)
- If your insurance company does not cover 3D/Tomosynthesis breast imaging we still offer the Standard 2D Breast Imaging upon request. Under the Affordable Care Act and Vermont laws, nearly all insurance carriers must cover the full cost of a Standard 2D Routine Mammogram without any expense to you (exceptions are rare). The required full coverage of Standard 2D Mammograms applies to annual screening mammograms for women 40 or older and to screening mammograms recommended by a healthcare provider for women under 40.
- If you are having a mammogram because of a breast problem, it is considered “diagnostic,” not screening. There may be a cost to you, as the charge for a diagnostic mammogram is usually applied to your insurance deductible. This is also true for mammograms that happen every 6 months rather than yearly.
- If you have had a screening mammogram and are called back for another mammogram or ultrasound, Vermont law requires that insurance carriers cover the full cost of those exams, without any expense to you (exceptions are rare).
- Insurance coverage for breast cancer screening can be confusing. See below for information about contacting our Patient Navigator if you have questions.
If You Don't Have Health insurance
Lack of health insurance should not prevent you from getting your mammogram. There are programs that help pay for mammograms, such as You First health screening program, funded by the federal government through the Vermont Department of Health (www.YouFirstVT.org).
Please call our Patient Navigator at 802-225-5449 to learn about the options for making breast cancer screening affordable.
Patient Navigation Services at Central Vermont Medical Center are available free of charge to all persons in the CVMC service area. The Patient Navigator’s job is to help individuals eliminate obstacles to getting the cancer care they need when they need it. The Patient Navigator serves as a guide through the health care system, from cancer screenings to treatment and beyond.