NRECA Medical Plan Now Covers 3-D Mammograms

The NRECA Medical Plan now covers digital breast tomosynthesis, commonly called 3-D mammography, retroactive to January 1, 2017. Cooperative Benefits Administrators (CBA) will reconsider claims received previously for 3-D mammograms. Participants do not need to resubmit claims, but they may receive explanation of benefits notices showing claim adjustments for dates of service for 3-D mammograms dating back to January 1, 2017.

The decision to provide a benefit for 3-D mammograms was made to address medical plan participants’ growing need for coverage for this procedure. In the last couple of years, the frequency of claims for 3-D mammograms has risen, and in some areas, the procedure is becoming the only option for mammography.

Summary of Material Modifications
Summary of material modifications (SMM) documents will be issued for all medical plans to reflect the new 3-D mammogram benefit. Benefit administrators can expect to receive a Message Center alert no later than April 15, 2017, notifying them that their medical plan SMMs are available for distribution.

If you have questions, or questions from your employees about the new 3-D mammogram coverage, contact your field representative. You also can contact the Member Contact Center at 866.673.2299 or contactcenter@nreca.coop.