Breast cancer is the most common cancer in women, and the second deadliest. Other breast issues are also identified by mammogram. Save the ta-tas!

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Cost
$0 in-network; 40% coinsurance out-of-network
Prior Authorization Required
No
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain an order for a mammogram from your loved one's primary care provider, OB/GYN, or other specialist.

  2. Schedule the exam at a network facility selected by the provider.

    • It is likely that the scheduling department of the chosen facility will reach out to schedule the exam.

    • Solis Mammography and SimonMed Imaging are also partner resources available for mammograms.

  3. Attend the appointment and complete the exam.

  4. Following results, engage in follow-up recommendations and/or referrals.


This is an eligible health activity in the Blue Medicare Health Rewards program. Completing a Breast Cancer Screening qualifies your loved one for a $30 reward. Once the health plan receives the self-attestation for each exam/screening click here to complete (or call the Member Outreach team at 1-888-267-9046, TTY 711), the reward will be loaded onto your loved one's AZ Blue OTC/Rewards Benefits Mastercard for use anywhere that accepts Mastercard.


For questions regarding the Blue Medicare Health Rewards program or issuance of the AZ Blue OTC/Rewards Benefits Mastercard, contact the Member Outreach team at 1-888-267-9046 (TTY 711).


IMPORTANT: The AZ Blue OTC/Rewards Benefits Mastercard is reloadable and will be used by the plan to load rewards, so make sure your loved one holds onto it to use throughout the year.

Availability
One time baseline mammogram (age 35-39); Mammogram every 12 months (age 40 and over); Clinical breast exam every 24 months

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Mammograms are annual imaging exams intended for the early detection of cancerous tumors in the breast tissue.  The exam also detects non-cancerous growths that should be further assessed and treated or monitored.  Breast cancer is the second leading cause of cancer death in women (the first is lung cancer). The chance that a woman will die from breast cancer is just 1 in 39. Early detection and early intervention are key to survival.

Any woman between the ages of 35-39 should obtain a baseline mammogram. Any woman aged 40 and over should have an annual mammogram, regardless of risk.  While there are factors that increase the risk for breast cancer—older age (50+), genetics and family history, sedentary lifestyle and obesity, hormone replacement therapy, and others—mammograms are now recommended annually for all women after 40, regardless of factors that have been associated with increased or decreased risk.

In addition to an annual mammogram, it is recommended that women receive a clinical breast exam by a qualified professional every two years.  Clinical breast exams are usually conducted during routine gynecological exams (also recommended and available every 24 months—see Cervical and Vaginal Cancer Screening benefit), though can be conducted independently if there is concern.  A clinical breast exam is done by visually inspecting and palpating (feeling with the hands and fingers) the breast tissue and lymph areas surrounding the breast—such as under the arm.

Likewise, women are encouraged to do monthly self-exams, or manual exams, which are best performed in or immediately after a hot shower.

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