The purpose of this document is to provide you with a brief summary of your breast health rights and additional
services that may be available to you in Oregon. You can also download the complete long-form version of this
document by scrolling to the bottom of this page.
If you have health insurance*
(Live in Washington State? Click here for Breast Health Rights specific to Washington State)
If you have health insurance and you have breast cancer symptoms, you need to know what services your health insurance plan is required to cover.
Women age 18 and older with health insurance are entitled to insurance coverage for complete and thorough clinical breast exams annually and at any time when recommended by the woman’s health care provider.
Women age 40 and over with health insurance are entitled to insurance coverage for an annual screening mammogram. No referral is necessary.
Women of any age with health insurance who have breast cancer symptoms or are at a high risk for breast cancer are entitled to insurance coverage for mammograms at any time with a provider's referral. (ORS 743A.100, 2007)
Insured women are entitled to insurance coverage, payment or reimbursement for full mastectomy care including breast reconstruction. (ORS 743A.110, 2007 and Women’s Health and Cancer Rights Act, 1998)
Insured breast cancer patients are entitled to insurance coverage for orally administered chemotherapy. (ORS 743A.068, 2007)
Insured women who are participating in clinical trials are entitled to insurance coverage for routine care despite their participation in clinical trials. (SB 316)
In addition, the State of Oregon Insurance Division includes a special section, the Consumer Advocacy Unit, which helps people resolve disputes with their health insurance companies about their coverage. The Consumer Advocacy Unit also provides information and educational programs about insurance coverage to the public. The Consumer Advocacy Unit may be contacted toll free at 1-888-877-4894.
* Accident only and specific disease insurance policies, other limited benefit polices, and coverage offered under an employer’s self-insured plan may not provide these benefits. Be sure to read your policy or check with your insurance provider before you seek services to verify coverage.
If you do not have health insurance
If you have symptoms and do not have health insurance, ScreenWise offers breast health services to qualifying low-income and uninsured women. Call 1-877-255-7070 to see if you are eligible.
Women ages 40-64 and women under age 40, with breast cancer symptoms, who meet the ScreenWise eligibility requirements may apply for no-cost breast cancer screening and diagnostic services through ScreenWise. The phone number is 1-877-255-7070. *
Women who are diagnosed with breast cancer through ScreenWise are entitled to breast cancer treatment services through the Oregon Department of Human Services. (Federal Breast and Cervical Cancer Prevention and Treatment Act)
Eligible women who are diagnosed with breast cancer are entitled to breast cancer treatment services through the Oregon Health Authority. (effective January 1, 2012).
* Susan G. Komen Oregon & SW Washington partners with the States of Oregon and Washington to provide these services. Services are restricted in the number of women that can be served by the limited funding that is available.