Get Jesse Story Prompts Review of Health Care Plan’s Mammogram Policy

getjesseThe state employee’s health care plan does not currently cover screening mammograms for women under 40 years old – even those in the high-risk category for breast cancer. But, thanks to a 36-year-old mother of two and a news reporter who drew attention to her story, this may soon change.

Yesterday, Jesse Jones at KING 5 News told the story of Joy Griffith, including an interview with SCCA’s Dr. Lehman about screening for women at high risk for breast cancer. Joy’s mother was diagnosed with breast cancer at age 46, so her doctor recommended she start screening early. Joy later found out her insurance, which is through the state employee’s plan, would not cover the mammogram. Washington state law says that a screening mammogram must be covered if a doctor recommends it, but the state employee’s plan is self-insured, so is not mandated to follow the law. Joy’s two appeals to the insurance company were denied, so she called Jesse.

Yesterday’s news story prompted the health care plan’s Chief Medical Officer, Dr. Daniel Lesser, to overturn the denial and cover Joy’s mammogram. In addition, he has called for a full review of the plan’s mammogram policy. Please click here to view Jesse’s original story about Joy. The follow-up story about the plan’s review of its current policy is here.

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