ALERT! A breast MRI (Magnetic Resonance Imaging) is covered only under very specific circumstances. Your provider must receive preauthorization before services are performed, or it may not be covered.

Women Ages 40 and Older

The plan pays 100% for one mammogram per calendar year for women ages 40 and older. If you get an additional mammogram within the same calendar year for the treatment of an existing medical condition (diagnostic mammogram), like a breast lump, the plan covers it under the medical benefit, subject to the medical deductible and coinsurance. If you receive two preventive mammograms in one calendar year, the second one is not covered.

ALERT! “Baseline” mammograms for women under age 40 are not covered.

The plan does not cover screening or preventive mammograms for women under age 40. If you receive a medically necessary mammogram to diagnose a medical condition (diagnostic mammogram), the plan will cover it under the medical benefit, subject to the medical deductible and coinsurance.