08 Nov Prevent Cancer Foundation Tool Compares Screening Coverage By Major Health Insurers
MedicalResearch.com Interview with:
Carolyn R. Aldigé
President of the Prevent Cancer Foundation
MedicalResearch.com: What is the background for this tool? What types of cancers are covered under this comparison tool?
Response: The coverage tool compares screening coverage by the 30 largest health insurers in the U.S. Consumers can use the tool to see their insurance plans’ policies on coverage of screening tests for breast, cervical, colorectal, lung and prostate cancers.
MedicalResearch.com: What are some of the differences in insurance coverage of screening tests?
Response: There is a sizable variation in what insurance plans cover, partly a result of differing screening guidelines from three leading organizations. Though insurance plans are required to cover screenings recommended by the United States Preventive Services Task Force (USPSTF) without a co-pay, many will choose to cover other screening tests as well—but which guidelines do they follow? This is confusing to both patients and providers.
Breast cancer screening is an area where we see big differences in insurance coverage. All 30 plans cover 2D mammography, but only 13 plans cover 3D mammography (tomosynthesis).
Colorectal cancer screening coverage also differs. While almost all plans cover colonoscopy, CT colonography, flexible sigmoidoscopy, and FIT and FOBT screening tests, there are differences in coverage of stool-based DNA tests.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our hope is that users take away clarity on their insurance plans’ coverage and/or come away with the information to talk to their health care providers about the cancer screenings they may need. Cancer screening is key to detecting cancer early when it’s most treatable, but the confusion surrounding screening guidelines and insurance coverage means many people aren’t actually getting these screenings. We hope this tool helps clear up the confusion so people can get to the doctor and get the screenings they need.
MedicalResearch.com: Is there anything else you would like to add?
Response: As you can see in the tool, there are many instances where an insurance company doesn’t have a stated policy about a particular screening test. This doesn’t mean it isn’t covered, but it also doesn’t mean it is—adding to the confusion among patients and providers. We hope insurance companies will also take a look at our review and fill the gaps in their coverage policies.
Screening tests are also only one strategy for cancer prevention and early detection. Up to 50 percent of cancer cases and 50 percent of cancer deaths can be prevented with the knowledge we have right now. The Prevent Cancer Foundation encourages you to be your own advocate for your health and make healthy lifestyle choices such as maintaining a healthy weight, eating a healthy diet, being physically active, protecting your skin from the sun, avoiding tobacco, getting recommended immunizations and knowing your family history. You can learn more at www.preventcancer.org.
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Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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