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High-Deductible Insurance Linked To Delays In Cancer Diagnosis And Treatment: Shots



The out-of-pocket expense of mammograms, MRIs and other tests and treatments can be several thousand dollars each year when you have a high-deductible health policy.
                
                
                    
                    Lester Lefkowitz / Getty Images
                    
                

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Lester Lefkowitz / Getty Images
        
    

The out-of-pocket expense of mammograms, MRIs and other tests and treatments can be several thousand dollars each year when you have a high-deductible health policy.

Lester Lefkowitz / Getty Images
            
        

In 2017, Susan learned that she carries a genetic mutation that may raise her lifetime risk of developing breast cancer to 72 percent

Her doctor explained that individuals who have this mutation in the BRCA2 gene have choices in treatment. Some people opt for preventive double mastectomy. But Susan could instead choose to undergo increased cancer screenings, which would mean an annual mammogram and annual MRI scan.

Because she had just had her first child, Susan chose increased surveillance – to maintain her ability to breastfeed

Both Susan and her husband, who make their home in Broomall, Pa., have an insurance provided through their respective employers to help pay for medical treatment. But there's a costly hitch: These annual scans she would need would be expensive, and their companies offered only high-deductible health plans

Susan's annual deductible for her plan (which covers her and her child) is $ 6,000 annually. (NPR has agreed to use only Susan's first name because she worries any publicity might jeopardize her job.)

"I've been working at my employer for 17 years," she says. "When I first started, there was no paycheck deduction for health insurance and my copay was only $ 5. But in 2011, my employer switched to only providing high-deductible insurance plans."

Susan went into her first mammogram and MRI in February 2017. Her out-of-pocket cost for MRI was more than $ 2,000. The bill for her mammogram was $ 1,088 (though she was eventually able to appeal and have the fees for the mammogram reduced to $ 191).

As a result of the high bill, Susan decided to put her 2018 annual screenings until she had

Susan's story of delaying care because she's underinsured is not an outlier. A study published last month in Health Affairs examined claims from a large national insurer for 316,244 women whose employers switched insurance coverage from low-deductible health plans (ie deductibles of $ 500 or less) to high-deductible health plans (ie, deductibles of $ 1,000 or more) between 2004 and 2014.