Mammograms
-
Ok I am 36 years old and curious about mammograms. I hear so many horror stories about young women with breast cancer and it blows my mind insurance won’t cover it until 40. Any advice on if you’ve gotten one covered and are under 40 with no symptoms? Or just advice on this subject in general?
-
I’m 34 and my (shitty) insurance covered it with no prior family history. Not sure how my OB coded it but I had no issues. I had ultrasound done too. I had dense breast tissue. My OB wasn’t overly concerned but sent me due to the significant increase in young(er) women being diagnosed.
-
My advice is to schedule it no matter the cost. I just turned 41, but have had several mammograms over the past 5-6 years due to a family history. I’m fairly certain if your Dr thinks you need one before 40 it can be covered regardless of family history. I was a teacher with mediocre insurance and had one at 30 and it was covered.
-
If you are concerned, you might have to embellish your story to include breast pain when you talk to your health care provider. This will allow them to prescribe a diagnostic mammogram and or an ultrasound. Unfortunately, regular mammograms for younger women are not as accurate because of the breast density. Ultrasounds are actually more accurate. At any rate you need to be doing self breast exams regularly.
-
Agree with what has been said here already. I was diagnosed with breast cancer at 43 and recommend regular self checks starting in your 30s, and mammograms if you’re able to get one. They aren’t perfect but better than nothing. Ultrasounds and MRIs tend to be more accurate for imaging but unfortunately insurance typically doesn’t cover unless a mammogram finds something first. Early detection is so important because it gives you a runway of time, treatment options and of course may save your life. Google “free or reduced cost mammogram” in your city to see what services are available— some orgs offer free screenings.
I also recommend getting genetic testing done to see if you have any of the genes that make you at higher risk for breast cancer, BRCA 1 and 2 and there are others. The Myriad genetic test screens for 48 different genes across several common cancers. Knowledge is power and we have to advocate for ourselves.
-
I wanted to get one at 38 and because my OB wouldn’t say I “needed” one I couldn’t find a place who would do it! I was willing to pay fully out of pocket too and I was told unless an OB said I had concerning spots and had to have one they won’t do them before 40. Which is insane to me. If your OB will work with you to order one that’s the only way before 40 usually. I was so shocked no one would take my money!
-
You're right that most insurance plans won’t cover a screening mammogram before age 40 unless there are significant risk factors (like a strong family history or genetic concerns).
However, if you're experiencing symptoms like breast pain, a lump, or changes, your provider can order a diagnostic mammogram and ultrasound, which are more detailed and typically do get covered — because they’re considered medically necessary.
Always worth checking with your provider to advocate for the right imaging based on what’s going on with your body.
