New e-Book Shows Inconsistent Insurance Policies for Cancer Screening

New e-Book Shows Inconsistent Insurance Policies for Cancer Screening

According to a new review by the Prevent Cancer Foundation, insurance policies covering screening methods for five types of cancer show significant inconsistencies across healthcare plans, even though cancer screening is considered one of the most important prevention tools.

Together with its review, the foundation released a new online tool that allows people to compare their plan’s coverage (by the nation’s 30 largest health insurers) of screening tests for breast, colorectal, lung, prostate, and cervical cancer in an easy, user-friendly way.

The e-book, titled “Cancer Screening: A Review of Guidelines and Insurance Coverage,” was published by Mary Ann Liebert Inc. publishers.

The review presents current screening tests and provides an overview of the American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN) and the U.S. Preventive Services Task Force (USPSTF) screening guidelines.

The e-book identifies some trends, including the fact that only 13 of the 30 insurance plans cover 3D mammographies for breast cancer screening; that virtually all plans cover low-dose computer tomography (CT) scans for lung cancer screening; pap tests (alone or in addition to HPV tests) for cervical cancer screening; tests for colorectal cancer screening; and 28 of the 30 plans cover prostate-specific antigen (PSA) screening tests for prostate cancer, even though it is not recommended for men at average risk by the USPSTF.

“People need to be aware that their health plans may not cover every screening test available for all the types of cancers that we can detect early, even if those tests are recommended by their physicians,” Carolyn R. Aldigé, Prevent Cancer Foundation’s president and founder, said in a press release. “When patients lack access to cancer screening tests, their lives are at risk and we collectively fail to deliver on one of the country’s greatest public health achievements.”

The online insurance coverage tool was developed using data generated by Policy Reporter. Screenings recommended by the USPSTF are mandatory for insurance companies to cover, although they may wish to add other screening tests as well.

For instance, breast cancer data shows a considerable number of plans without a policy:

  • 2D mammography: 132 plans covering; 0 plans not covering; 274 plans without policy;
  • 3D breast tomosynthesis: 47 plans covering; 45 plans not covering; 313 plans without policy.

This scenario is seen not only in breast cancer screening, but it highlights an inconsistency regarding the ACS, NCCN, and USPSTF guidelines.

The e-book also contains a selection of previously published studies examining the impact of cancer screening on patient outcomes.

“While your insurance company may pay for a test even if it does not have a specific policy, this information suggests that patients should talk to their insurance companies about coverage and demand a change if these critical screening tests are not being covered,” Aldigé said.

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