Coverage of mammograms for women under age 40 (effective July 19, 2013)

Effective July 19, 2013: UMP policy changed regarding coverage of mammograms for women under age 40 who are at increased risk of developing breast cancer as described below.

Note that services received before July 19, 2013, will not be paid or reprocessed under this new policy.

For women under age 40, the plan covers screening mammography for women who are at an increased risk for breast cancer. The service must be ordered by a health care provider, and the claim must be billed with an “at risk” diagnosis to be payable under the preventive care benefit.

What if I am not “at risk”?

Women under age 40 who receive a mammogram that is not for an “at risk” diagnosis may have services paid as a diagnostic (medical) mammography under the “Diagnostic Tests, Laboratory, and X-Rays” as a medical benefit. The service must be ordered by a health care provider and billed as a diagnostic mammogram.

For questions about UMP coverage, call UMP Customer Service at 1-888-849-3681.

Women under age 40 enrolled in UMP in July 2013 received a letter regarding this change.

See the 2014 Mammogram benefit  for women enrolled in UMP.