If you have insurance, then the cost of your annual mammogram is covered. But there are some funny loopholes worth mentioning.

For example, if you are a Medicare recipient, your next screening mammogram must be done 366 days or more after your last one. So if you go on day 365 — exactly one year later — it won't be covered. No exceptions. For some people, that’s a budget-busting expense. Generally, insurance companies are more flexible and will be willing to cover a mammogram even if it is up to six weeks before the anniversary date.

If the screening mammogram shows an abnormality, and a diagnostic evaluation is necessary that involves additional imaging, more and more insurance companies are requiring that a new approval be obtained before proceeding with this additional testing. That is a hardship, since the radiologist may be willing and able to do the additional tests then and there, thus providing you with more definite findings while you’re still at the mammography facility. 

Some insurance company policies are so silly that they require the additional images to be taken at least one day later, so that they’ll show a different date than that of the screening mammogram.

What happens if a woman has no health insurance? She can still get a mammogram. Most breast centers offer free mammograms to underserved women who lack insurance and meet certain financial criteria. These free mammograms are paid for by grants from a variety of sources.

What if she doesn't have insurance but has a job and financial means? She should get insurance. Anyone without health insurance is playing Russian roulette with their health and their savings. One serious illness can wipe them out financially for a long time, maybe forever.

If she’s unwilling to get insurance, then she should give herself a gift for her next birthday and pay for her mammogram out of pocket. It will help ensure that she’ll have future birthdays to look forward to.