Insurance Guide for Breast Cancer: Honoring Breast Cancer Awareness Month

Every October, Breast Cancer Awareness Month is celebrated by breast cancer advocacy organizations that educate people about breast cancer risk factors and encourage people to undergo recommended screenings that may detect breast cancer early. Health insurance can help cover eligible breast cancer screenings and treatments, but if you’re not insured, state programs and charities may be able to help reduce your health care costs.

Breast Cancer Awareness Month is an annual observance focused on education and proactive screening to help reduce the number of breast cancer deaths.

For more information about breast cancer health insurance coverage and how to celebrate Breast Cancer Awareness Month, keep reading below.

On This Page

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  What Is Breast Cancer Awareness Month?

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  Who Should Be Screened for Breast Cancer?

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  Does Health Insurance Cover Mammograms?

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  Why Might You Receive a Bill After a Mammogram?

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  What About BRCA Genetic Testing and Counseling?

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  Breast Cancer Screening Without Health Insurance

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  What Happens if Your Mammogram Finds Something?

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  How Does Health Insurance Cover Breast Cancer Treatment?

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  Breast Cancer Awareness Month at a Glance

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  How To Use Breast Cancer Awareness Month To Check Your Coverage

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  Frequently Asked Questions

What Is Breast Cancer Awareness Month?

Breast Cancer Awareness Month is a global campaign aimed at raising awareness about the prevalence and impact of breast cancer. Common goals for Breast Cancer Awareness Month include helping patients who have already been diagnosed with cancer, teaching people about potential risk factors, encouraging individuals to be screened for breast cancer and raising funds to support breast cancer research.^[1]

When Is Breast Cancer Awareness Month?

Each year, Breast Cancer Awareness Month is recognized in October. Additionally, several related observances may take place during Breast Cancer Awareness Month. For example, the following observances were recognized in 2025:^[2]

Breast Cancer Awareness Month History

The first weeklong breast cancer awareness campaign was organized by the American Cancer Society and Imperial Chemical Industries in 1985 — establishing a tradition that eventually evolved into an annual, monthlong campaign. In 1992, SELF magazine editor-in-chief Alexandra Penney and Estée Lauder senior corporate vice president Evelyn Lauder were the first people to distribute pink ribbons to support Breast Cancer Awareness Month.^[1]

The pink ribbon remains a widely recognized symbol of breast cancer awareness, and many people wear one while participating in fundraising or other charity events related to breast cancer.

Why Breast Cancer Awareness Month Matters

Breast Cancer Awareness Month matters because of how common and serious breast cancer is — especially among women. Roughly one in eight women in the United States will get breast cancer at some point in their lives, and more than 40,000 women die from the disease annually. Although rare, it’s also possible for men to get breast cancer, with male patients accounting for less than 1% of all breast cancer cases.^[3]

Domestic and international organizations use Breast Cancer Awareness Month to promote cancer prevention and try to lower the mortality rates associated with breast cancer. Since 1989, the rate of breast cancer fatalities in the United States has fallen by 44%.^[2] Encouraging people to get screened for breast cancer is a crucial way to catch the disease early and potentially save lives.

Breast Cancer by the Numbers

Here’s an overview of breast cancer statistics you need to know this October:^[3]

1. Breast cancer is the most common cancer among women, accounting for about 32% of newly diagnosed cancers in American women each year.
2. Women over the age of 50 account for nearly 85% of breast cancer diagnoses.
3. Around two-thirds of breast cancer patients are diagnosed before the cancer has spread outside of the breast.
4. Over 4 million women in the United States have either survived breast cancer or are currently being treated for it.
5. Black, American Indian and Alaska Native women have a lower risk of contracting breast cancer than white women, but they also have a higher risk of dying from it.
6. The risk of contracting breast cancer is almost twice as high for women with a close relative who has had it, such as a sister or mother.

Who Should Be Screened for Breast Cancer?

Most women are advised to get screened for breast cancer periodically starting at age 40. However, exact recommendations may vary, depending on your personal risk of developing breast cancer.

Current Mammogram Recommendations

According to the American Cancer Society, women with an average breast cancer risk should start getting mammograms at age 40. They’re advised to undergo screenings every year from ages 45 to 54, while they may scale back to getting screened once every two years starting at age 55. In general, it’s a good idea to continue getting annual or biennial mammograms for as long as you’re in good health and expect to live for at least another decade.^[4]

You may qualify as average risk if you:^[4]

• Don’t have a personal or family history of breast cancer
• Didn’t undergo chest radiation therapy prior to age 30
• Don’t have a mutation in your BRCA1 or BRCA2 gene that raises the risk of breast cancer

What if You Have a Higher Risk for Breast Cancer?

High-risk women need to be more proactive about breast cancer screening, with the American Cancer Society recommending both mammograms and breast MRIs every year from age 30 onward. You may have a higher risk of developing breast cancer if you:^[4]

• Are considered to have at least a 20% chance of getting breast cancer in your lifetime based on your family history and other risk assessment tools
• Underwent chest radiation therapy prior to age 30
• Have a mutation in your BRCA1 or BRCA2 gene that raises the risk of breast cancer — or are closely related to someone with such a genetic mutation
• Have or are closely related to someone who has Bannayan-Riley-Ruvalcaba, Cowden or Li-Fraumeni syndrome

Does Health Insurance Cover Mammograms?

Under the Affordable Care Act, health insurance plans are required to cover certain preventive services related to breast cancer, including breast cancer screening mammograms (with or without a clinical breast examination) for women ages 40 and up. ACA health plans must also cover chemoprevention counseling to help high-risk women determine whether they should take certain medications proactively to try to prevent the onset of breast cancer.^[5]

Keep in mind that coverage specifics may vary based on the type of health insurance you have. For example, Medicare covers a one-time baseline mammogram for women between the ages of 35 and 39, annual screening mammograms for women ages 40 and older and diagnostic mammograms anytime a doctor determines that they’re medically necessary — even if this occurs more than once per year.^[6]

Are Mammogram Screenings Free With Insurance?

Mammogram screenings are often free with insurance because they’re considered preventive care benefits. Plans from the Health Insurance Marketplace usually cover 100% of the costs for preventive services provided by in-network health care professionals, meaning you won’t have to pay a copay or coinsurance out of pocket — even if you haven’t yet hit your deductible for the year.^[5]

Screening Mammogram vs. Diagnostic Mammogram

How your health insurance covers mammograms may depend on whether your mammogram is strictly precautionary or whether it’s done in response to a possible warning sign. See the following table for a breakdown of how coverage may differ between screening and diagnostic mammograms:^[6][7]

Why Might You Receive a Bill After a Mammogram?

Even if you’ve passed your deductible, you’ll likely receive a bill after a diagnostic mammogram, since it’s not considered a preventive care benefit.^[7] In addition, there are some cases where you may encounter out-of-pocket costs even after a preventive screening. For example, your insurance company isn’t required to cover the full cost of your screening mammogram if you receive it from a provider outside of your health plan’s network.^[5]

Furthermore, some plans may place restrictions on when or how often you can get a free mammogram. Health insurance companies are only required by law to cover mammograms every one to two years beginning at age 40.^[5] As a result, you could have to pay for your mammogram out of pocket if you get one in your 30s or choose to get screened multiple times per year.

What About BRCA Genetic Testing and Counseling?

ACA-compliant health plans must cover genetic counseling if you have a high breast cancer risk and may cover genetic testing if your primary care physician recommends it. Genetic counseling involves going over your family and medical history with a health care professional to determine whether you should undergo genetic testing, while genetic testing involves checking whether you have a mutated BRCA gene that raises your cancer risk.^[8]

Breast Cancer Screening Without Health Insurance

Without insurance, mammograms cost around $400 to $660 on average — so you’ll likely want some other kind of financial assistance if you don’t have breast cancer health coverage.^[9] Contact your state or local health department to see if you’re eligible for any screening programs. For example, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) offers free or low-cost screenings to uninsured individuals.^[10]

What Happens if Your Mammogram Finds Something?

Read the following sections for an overview of what your next steps may be if your mammogram uncovers something that could be indicative of breast cancer.

Follow-Up Imaging

If the radiologist notices what could be a cyst or a mass on your breast, you may be asked to come back for another appointment, during which you may undergo a diagnostic mammogram and potentially an ultrasound of your breast. Even if the follow-up imaging doesn’t reveal anything concerning, you may be encouraged to return to the hospital for your next mammogram early — potentially within six months.^[11]

Biopsy and Diagnostic Testing

In the event that your follow-up screenings also produce suspicious results, you may need to undergo a biopsy to definitively determine whether you have breast cancer. During a breast biopsy, tissue is removed from your breast through a needle or a small incision. Then, the breast tissue is evaluated under a microscope to see whether cancerous cells are present.^[11]

If Breast Cancer Is Diagnosed

If the results of your biopsy show that you have cancer, you’ll be referred to a breast cancer specialist so you can undergo any necessary follow-up tests and begin making a treatment plan. The American Cancer Society recommends taking the following steps before and during your meeting with your oncologist:^[11]

1. Prepare a list of questions you intend to ask.
2. Bring a trusted friend or family member with you for moral support.
3. Take notes or record the conversation to make sure you retain all the information you need.
4. Ask clarifying questions throughout the appointment to make sure you understand the medical terms used by your doctors and nurses.

How Does Health Insurance Cover Breast Cancer Treatment?

Health insurance generally covers breast cancer treatments, such as chemotherapy, surgery, prescription drugs and other related medical services. However, since these aren’t considered preventive benefits, you may need to pay a copay or coinsurance each time you receive cancer care. Nevertheless, health insurance can substantially reduce the out-of-pocket costs associated with breast cancer treatments.

According to a 2020 study, the combined cost of medical care and medications for breast cancer averages nearly $80,000 during the last year of a patient’s life.^[12] However, a 2023 study found that women with employer-sponsored group health insurance spend an average of about $1,500 per year out of pocket to receive treatment for invasive breast cancer — a fraction of the total cost for patients without breast cancer insurance coverage.^[13]

Breast Cancer Awareness Month at a Glance

1. Breast Cancer Awareness Month is an annual campaign recognized each October that emphasizes the importance of getting screened for breast cancer and being aware of risk factors that may make you more likely to develop breast cancer.
2. Tens of thousands of women die from breast cancer each year, but thanks to an increase in breast cancer awareness, fatality rates have declined over the past 40 years or so.
3. Most women should receive a mammogram every year or two starting at age 40. If you have a high risk of developing breast cancer, you may need to start getting mammograms earlier or get them more often.
4. Purely preventive screening mammograms are generally free with health insurance as long as you receive them from an in-network provider. However, diagnostic mammograms that investigate potential signs of breast cancer may require copays or coinsurance.
5. The Affordable Care Act also requires health insurers to cover other preventive care benefits related to breast cancer, including chemoprevention counseling and genetic testing or counseling.
6. Health insurance and Medicare plans generally cover chemotherapy and other cancer treatments, though you should be prepared for out-of-pocket costs whenever you receive these services.

How To Use Breast Cancer Awareness Month To Check Your Coverage

To confirm whether you have sufficient breast cancer screening insurance this Breast Cancer Awareness Month, take the following steps:

1. Research relevant breast cancer screenings and treatments, and look up whether and how insurance typically covers them.
2. Check your health plan’s documents for specific details about your coverage.
3. Contact a representative from your health insurance company if you have any questions about your coverage.
4. If you aren’t covered by health insurance, look into nonprofits that may be able to help cover screening costs.
5. Reach out to your loved ones who may be at risk of developing breast cancer, and encourage them to make sure they have adequate coverage or access to financial help.