VNS Health Total: Breast Cancer Screening (Mammogram)

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!

 Read
Cost
$0
Prior Authorization Required
No
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain a network provider order for a mammogram.

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

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

  3. Attend the appointment and complete the exam.

  4. Upon results, engage in recommended follow-up treatment or referrals.

  5. If transportation is needed to and from the appointment:

    • Call (877) 718-4219 (TTY: 711), M-F 8am-8pm, at least 48 hours in advance of the needed transportation.

    • Have the date, time, location, and reason for transportation ready when calling.

    • Receive authorization and guidance on scheduling the transportation service.

    • Get confirmation of scheduled transportation.

    • Use the transportation service to and from the appointment.

This is an eligible health activity in the VNS Health Rewards Program. Completing a Mammogram qualifies the member for a $25 gift card. Once the health plan receives the claim that this activity was completed, a gift card will be issued to the member. For questions regarding the Rewards Program or issuance of a gift card, contact the VNS Health Total Care Team at (866) 783-1444 (TTY: 711).


Note that gift cards are generally mailed out about 3 months after the close of the quarter in which the activity was completed. For example, if an activity is completed in February, the quarter closes at the end of March, and the gift card will be issued in June. If an activity is completed in the fourth quarter of the year (October - December), the gift card will be issued in March of the following year.

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

Everything you need is all in one place

Helpful app simplifies family caregiving by combining your loved one’s insurance benefits and medical records into one user-friendly platform while enhancing your caregiving skills

banner

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.

Go to all guides

About us

Helpful is an app to make caregiving easier. We integrate your loved one’s insurance benefits, medical records and caregiving guides into an immediate, accessible and user-friendly experience. Helpful supports your care needs by eliminating administrative tasks and providing technology to support your caregiving experience.