13533

Member for

7 years 10 months
Submitted by Site Factory admin on
Routine mammograms as recommended and determined suitable by the member's health care provider. As required by state law coverage includes at least one baseline mammogram during the five-year period a member is age 35 through 39 and one mammogram each calendar year for a member age 40 or older. For members determined to be at high risk" for breast cancer a provider may recommend a screening mammogram outside of these time periods. Providers may also recommend further diagnostic examinations for breast cancer (such as diagnostic mammography digital breast tomosynthesis breast magnetic resonance imaging or breast ultrasound) to evaluate an abnormality in the breast that is seen or suspected from a screening examination for breast cancer or that is detected by another means of examination or that is suspected based on the member's medical history or family medical history. Coverage for these covered services is the same as routine mammograms."