UnitedHealthcare commits to covering 1st diagnostic breast imaging exam
UnitedHealthcare is committing to covering the first diagnostic breast imaging exam for certain commercial plan members beginning in 2026.
The country’s largest private insurer noted that the number of women diagnosed with the disease has risen steadily since the mid-2000s. In fact, breast cancer is now the most common type of cancer in the U.S., UHC said.
In response to these trends, certain UnitedHealthcare fully insured health plans will have expanded benefits beyond regular screenings. Its committing to cover the costs of the first diagnostic breast imaging exam—and initial diagnostic colorectal cancer detection service—at “no cost to the member.”
“By eliminating this sometimes-significant cost, UnitedHealthcare is working to remove barriers to care and help encourage quicker follow-up screenings or an earlier diagnosis,” the company said in a July 31 announcement. “This, in turn, can lead to better outcomes, cost savings for employees and their employers and, ultimately, a healthier workforce.”
Factors such as an inconclusive screening mammogram, dense breasts or a genetic disposition to the disease can necessitate additional imaging, such as breast MRI or ultrasound. However, gaps in insurance coverage may force women to pay anywhere from $234 for a diagnostic follow-up mammogram to over $1,000 for an MRI, according to Susan G. Komen. These added costs lead to 1 in 5 women opting to forgo additional testing if they don’t have the funds, a study in Radiology found. Numerous states have passed bills requiring payers to cover follow-up breast imaging, while lawmakers in Congress have pushed a national fix.
UnitedHealthcare noted that 7 in 10 employers have reported a growing prevalence of cancer among employees and dependents, according to one recent survey. It says the new cancer benefit is part of UHC’s efforts to “close gaps in care and improve the consumer experience.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.