If you are an Oxford member, please read below to learn about
Oxford’s Diagnostic Mammogram Guidelines:
- One (1) baseline screening mammography for women age 35-39
- Routine (1 per year) screening mammography for women age 40 or
greater
- One screening mammography will be allowed yearly for women
under the age of 39 when prescribed by a physician for any woman
based on physician evaluation or recommendation
Oxford Health Plans will reimburse one screening mammography per
year (providing at least 10 months have passed since the previous
mammogram). Diagnostic mammography services are indicated for any
one of the following:
- Signs and symptoms suggestive of a breast disorder, i.e.
malignancy
- Radiographic abnormalities detected on screening
mammography
- Short interval follow-up (at six month intervals, for two
years) necessary for unresolved clinical/radiographic concerns
- Follow-up of an established history of a breast malignancy
- When prescribed by a physician for any woman based on physician
evaluation or recommendation. A screening mammography is not
covered for males; however, a diagnostic mammography may be
performed according to the guidelines above.
For more information, please call (718) 990-2363.