Medicare coverage, supplemental insurance, and the use of mammography by older women

American women age 65 or over may not pursue mammography screening for breast cancer because they have to pay part of the cost. An analysis of Medicare bills in 1991 and 1992 of 4,110 women 65 and over revealed that only 36.9% took advantage of the screening mammography benefit of Medicare. Medicare pays for most of the cost of screening mammography, but people without supplemental insurance have to pay copayments, deductibles, or balance bills. Balance bills are issued by health care providers who charge above the Medicare amount. Less than 15% of women without supplemental insurance had mammography, compared to 44.7% of women with employer- supplemented insurance, 40.1% with self-purchased supplemental insurance, and 23.9% with Medicaid supplemental insurance.