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A woman in Washington state discovered that unlike mammograms, breast MRIs aren’t universally covered as zero-cost preventive care.
A woman in Washington state discovered that unlike mammograms, breast MRIs aren’t universally covered as zero-cost preventive care.
Last year, Stephanie Halver’s primary care doctor consulted a risk assessment tool to calculate her chances of one day developing breast cancer. Halver, now 43, remembered the likelihood “popped up really high.”
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That’s partly because Halver’s mother and aunt have had breast cancer. Her age and dense breast tissue also put her at higher risk.
Halver, who lives in Vancouver, Washington, said her doctor recommended she get an annual breast MRI, six months after her yearly mammogram. The scan would serve as an additional safeguard, since breast MRIs can detect abnormalities that mammograms miss.
Case in point, actress Olivia Munn had a breast MRI in 2023 that detected an aggressive form of cancer in both breasts, even though a recent mammogram had been clear, she told People magazine. Like Halver, Munn said her doctor recommended the MRI after a risk assessment score showed she faced a greater-than-normal chance of developing breast cancer.
Catching breast cancer early, before it spreads, improves survival rates, according to the National Cancer Institute. After Halver’s insurer preapproved the scan, she scheduled the MRI for September.
A breast MRI — short for magnetic resonance imaging — is a preventive and diagnostic tool that captures pictures of breast tissue in higher detail than a mammogram. MRIs may be recommended for patients at an increased risk for breast cancer, including those with dense tissue, a family history of breast cancer, or certain genetic markers.
But the scans are generally not recommended for women considered at average risk, according to the American Cancer Society, because they can also yield false positives, subjecting patients to unnecessary follow-up tests and procedures.
Breast MRIs are also used to diagnose cancer when an abnormality is detected during a mammogram, and they can determine the cancer’s stage after diagnosis.
$1,205: After an insurance payment of $13.90, the patient was responsible for $1,191.10. The clinic also charged $65.60 for “Injectable/Oral Med,” often used to keep patients still or less anxious during the scan. Halver’s insurance covered about half of that charge.
When Halver received the bill from Vancouver Clinic, where the MRI was conducted on Sept. 26, she was confused.
