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WATCH LIVELocalWeatherTeam 12 InvestigatesThe Real Dealbe Well


SEAFORD COUPLE: MEDICARE BREAST CANCER SCREENING COVERAGE CHANGE PUTS WOMEN'S
LIVES AT RISK

Oct 31, 2023, 1:20pmUpdated 1h ago
By: Jon Dowding
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A Seaford couple says a change in Medicare coverage of a breast cancer screening
test puts tens of thousands of women’s lives at risk.
Michael and Amy Gillman say it all started when Amy went in for her annual
breast ultrasound test in June to check for breast cancer. Their radiologist
told them about an unexpected change in Medicare coverage.

"They'd no longer be paid by Medicare for the breast ultrasound, and we had to
promise to pay the fee, whatever it might be, for the ultrasound knowing in
advance that Medicare would not pay for it,” said Michael Gillman.


Michael says for the last seven years, they’ve never had a problem and never
were notified about the change prior.
"Medicare had covered the service in full. They no longer do so. This was quite
a shock,” he said.
Amy gets an ultrasound in place of a mammogram because doctors say she has dense
breasts, which make it harder for mammograms alone to detect cancer.
Stony Brook Medicine Chief of Breast Radiology Dr. Cindy Lee says Amy is not
alone. Lee says women should start getting checked for breast cancer by at least
age 40. She says half the women in the U.S. have dense breasts and ultrasounds
are the best ways to detect cancer early in those women.
"With the ultrasound added on, in addition to the mammogram, you can find an
additional two to four cancers for every 1,000 women we screen,” she said. “It's
really adding a lot of that additional cancer detection."
Lee says Medicare’s coverage change puts thousands of women at risk for
developing breast cancer since this method of preventative screening isn’t fully
covered anymore by Medicare.
Gillman says Medicare told them the test would be covered, but only in specific
circumstances.


"They won't pay for it until the woman already has signs of cancer,” he said.
“This is not what a screening test is for. Breast cancer must be diagnosed
before it has symptoms."

As he awaits a response from the AARP and Medicare about the change, he has a
few questions for Medicare administrators.
"Is human life so worthless that you really feel that this is the way to go,” he
said. "How can you deny a test that is known to diagnose cancer early enough to
be easily treatable to tens of thousands of women who need it?"
Lee says people should check with any supplementary insurance plans to see if
they’ll cover the procedure as a preventative measure. She also says people with
questions about why the change happened should reach out to their congressional
representatives and have them urge Medicare to cover ultrasounds.
While the cost varies depending on people's insurance plans, the Gillmans say it
would cost them hundreds of dollars out-of-pocket to pay for the procedure.
Share this story




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