MRI coverage

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Jspero13
Jspero13 Member Posts: 2
edited January 2018 in High Risk for Breast Cancer

Hi, I have BRCA2 and I'm having trouble getting a MRI screening covered since it's considered "diagnostic" only mammograms are covered. My mother and aunt however do not have the same issue. Any advice in getting an MRI screening covered?

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  • gb2115
    gb2115 Member Posts: 1,894
    edited January 2018

    Can the ordering doctor fill out paperwork for a medical exception? With the right paperwork, insurance decisions can be overridden.

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  • Jspero13
    Jspero13 Member Posts: 2
    edited January 2018

    Thanks! I am going to check with my doctor to see if they can provide a letter. The frustrating thing is I live in NY state and the state has a new law that states any diagnostic procedure, including MRIs, should be covered and not come form my deductible or co-insurance, BUT my insurance is Blue Cross Blue Shield of Illinois, apparently because it is an Illinois plan they abide by federal laws, not state laws.

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