Consumer Alert: Know Whether Your Policy Covers New Tests
Madison, WI—Insurance Commissioner Ted Nickel reminds consumers that they should check their insurance policy before receiving medical care, especially for newer medical tests and procedures.
"It is important for consumers to understand that most, but not all, services ordered by a medical provider are covered by your health plan," stated Commissioner Nickel. "Make sure to check your policy, especially if your provider is suggesting that you receive a relatively new medical test."
Recently, the Office of Commissioner of Insurance (OCI) has received inquiries about a new medical test known as "3-D mammography" or digital breast tomosynthesis. The United States Preventive Services Task Force, which determines when a new test is accepted as preventative, has not yet accepted 3-D mammography as an effective preventative test and has not approved the 3-D mammogram as an alternative to women receiving standard mammograms.
Consumers should follow the steps below to get the most out of their health insurance policy:
- Read your policy. It is important for you to read your entire health insurance policy to understand how your services will be covered.
- Ask questions. If you are receiving a medical test, you should check with your provider on the cost of the test and ask if it is normally covered by insurance. Some services may even require the provider to pre-certify the service.
- Call your insurer. If you have any questions about whether or not a service is covered, you should check with your insurer.
Consumers are also reminded OCI staff is here to help. You can contact us toll-free at 800-236-8517 or by e-mail at
Created by the Legislature in 1870, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.