by Shannon Simcox
Zeta Cross, of Erdenheim, is a real estate agent affiliated with Elfant Wissahickon. She has multiple high-risk markers for breast cancer, including a family history of the disease.
Because of this, she gets an annual mammogram – that is, when she can afford it.
A mammogram, according to the National Cancer Institute website, is an X-ray picture of the breast, and the institute recommends that women over the age of 40 undergo a screening mammogram once every one to two years.
Last year, Cross did not go for her mammogram – much to her physician’s dismay – because she simply did not have the cash to cover it. This year, however, she decided she could not take the risk and went to the Chestnut Hill Women’s Center, where she has been going to get her mammogram for more than 10 years.
Cross told the receptionist that her insurance did not cover the mammogram in previous years. When, she went for her appointment, she handed in her insurance card and paid the $200 she was told her mammogram would cost. But when she began to receive applications for Medicaid in the mail, she knew something was amiss.
“It made me very mad to think the taxpayers would have to pay for my mammogram,” Cross said.
She was left with a bill of more than $2,000.
Although Cross laughs about the situation, she said she is particularly bothered by not being notified that the price had gone up. In past years, Cross said she had been charged as much as $650, significantly less than the bill she now faces paying.
The cost for mammograms varies depending on the type of procedure, according to Catherine Brzozowski, director of marketing for Chestnut Hill Hospital. In an e-mail, she wrote that programs at the Chestnut Hill Women’s Center discounted mammograms depending on the patient’s financial circumstances. She also noted that the hospital had service personnel for individuals who find their bills confusing and counselors to help navigate insurance and payment issues.
According to healthcarebluebook.com, the average cost for a mammogram in this area is $112, which should include the physician and technical fees.
Cross is currently looking into what her insurance company can do about the bill. Cross said she recently renewed her insurance policy with Assurant Health, which she described as “a very good price-friendly insurance option.” Her new plan, which she credited to the healthcare legislation, costs slightly less and has more coverage, including coverage for annual check-ups.
Under the legislation, Cross said she was told by Assurant Health representatives that her mammogram should be covered. Because she was in the wrong network, however, she still has no solid answer other than to wait and see.
If she is forced to pay this bill, which Cross jokingly said could buy her a piano, she believes she will go to her doctor and be referred elsewhere for her annual mammogram.
“It’s supposed to be much better if the same person reads your mammogram every year,” Cross said.
If she is forced to switch, it will be a whole new set of eyes looking at her films, eyes that have not seen her past X-rays. But, with her family history of breast cancer, Cross cannot take the risk of not getting a mammogram annually because of financial constraints.
Abington Health Systems is one of the local options for women in need of a mammogram but who are uninsured. Pat Conway, supervisor of the patient services center of Abington Health Systems, said the regular price for a diagnostic bilateral screening mammogram is $414, with an uninsured rate of 50 percent – $207.
Abington also offers patients the opportunity for medical and financial assistance as well as a payment plan, Conway said. In addition, Abington holds free screenings in the fall and spring of every year for uninsured and underinsured women, according to Linda Millevoi, director of media relations.
Upcoming events are planned for March 15 and April 20, 2011, at Abington’s Mary T. Sachs Breast Center in Willow Grove, Pa. Interested women can call 215-481-2204 to register.
Along with the general programs in the Chestnut Hill Women’s Center, the center hosts the Linda Creed Foundation. The program, held annually and occurring in the spring, is free for eligible women. To make an appointment, women should call 215-248-8359 in February.
Also, qualifying women can be a part of the Healthy Women program, funded by the Department of Health and Centers for Disease Control and Prevention, according to Brzozowski, who described the program as a free breast and cervical cancer early detection program. To find out qualifications, women can call 215-248-8395.
Cross continues to navigate the waters of insurance and billing. With the help of representatives from CHWC and her insurance company, she will eventually get her bill situation resolved, but for now, she said, “I think it’s good for the community to know.”