That mammogram we wanted you to pay for? You can’t pay for it.

Filed Under: Costs, Health plans, Patients

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Our friend who was  ordered to get a second mammogram, which was not covered by insurance, wrote to us again (if you missed it, here’s her first post.) 

The day of my second mammogram coincided with news of Angelina Jolie’s double mastectomy.  I was convinced I had breast cancer.

I had been told that I needed a second mammogram with very little explanation other than I knew I had to pay cash for it because my “testing budget”  had been expended under my insurance plan, and because the doctor wanted to see “another view.”

When  my turn came, the clerk sent me to radiology. When I got there, the clerk asked for my insurance card, and I reminded her I was paying for the test myself. She said she knew nothing about that, then directed me back to the waiting room I had started in.

The time of my scheduled appointment was near. I had a business appointment, and  I was willing to write a check to get my test taken.

The patient representative appeared and ushered me to a room. She said she was the one who gave me

the estimated self-pay cost of about $365 for the second test. If I recalled, she said, first my application would have to be rejected by the insurance company before I could pay out of pocket.

I did not recall. I only recall that when it was suggested the hospital might be able to nudge the insurance company into paying, no one returned my call.

I did not want to deal with getting a whopping bill for the second test. I had already knew my insurance company would reject it. Couldn’t we just cut to the chase and avoid me having to negotiate later to a self-pay rate?

No. The best I could get was the direct phone numbers of the patient representative and the billing supervisor and their pledge that they would remember me and this conversation.

I had the option to walk out, and take my breasts elsewhere. I finally decided to stay because I wanted the test done — it had already been three months and I felt as if a time bomb was ticking.

The technician was patient and told me she was paying off a colonoscopy at  $10 per month because her medical insurance had such a high deductible. “If you are ever in a position where you get a medical bill you cannot pay, just pay off a set amount every month and they can’t hurt your credit rating.”

She checked with the hospital administrator to confirm this was in fact the case.

Because of the situation, the technologist took my x-rays immediately to the radiologist to review just to make sure no third test would be requested —  that would  also not be covered by health insurance

The technician came downstairs to tell me all was good. I was told I needed a second mammogram because I have “young breasts” and the radiologist wanted to see them from a different angle. The density of tissue and lack of a benchmark test made her want to be absolutely certain.

I exhaled and said a little prayer of gratitude. I need to get myself mentally fit for the paperwork to come.