Weekly Q&A: Will Insurance Cover CA 125 Test?
E. asks, "Insurance in the U.S. will not cover the CA125 prior to cancer
diagnosis, so why do you state in your ovarian cancer article that women should
expect to get the test as part of a medical exam to check for ovarian cancer?"
She went on to state "THERE IS NO TEST FOR OVARIAN CANCER".
Often there seems to be confusion about the uses of the CA125 test in regards to ovarian cancer. I am assuming that the writer was referring to the use of CA125 as a screening test. There are a lot of reasons why the test isn't used for universal screening of women as, for example, a Pap test is. The main problem is that too many "false positives" and "false negatives" are associated with the test for it to be an adequate test when used in this manner. It is absolutely true that most insurance will not cover routine screening of women without symptoms using the CA125 test, except in the case of women at high risk for the disease.
Insurance will pay for the test to be used to follow the disease once cancer has been definitively diagnosed. But what about the middle ground, where there are symptoms, but no diagnosis?
Since insurance coverage varies so much, not only from policy to policy but in various parts of the country, I decided to turn to the wonderful women of ACOR's Ovarian Problems Discussion List to find out what their experiences had been with payment for CA125. Out of the 16 women who responded to my question about insurance coverage, all had had the test ordered by their doctors prior to diagnosis and only one had difficulty with payment. Three had gotten regular CA125 tests (either every 6 months or every year) as a result of being judged to be at a high risk for the disease. Sean Patrick, ovarian cancer survivor and co-developer of the Johns Hopkins Ovarian Cancer Web Site says that she has found that doctors can generally get tests including the CA125 paid for if submitted as a necessary procedure. She also says that in her experience that prices for the test usually run between about $55 and $125 if the woman pays for it herself.
As far as "there is no test for ovarian cancer" - other than biopsies, there is no definitive test for any kind of cancer. The CA125 blood test is only one of a group of tests used to detect an ovarian abnormality suspicious enough to warrant a more invasive procedure.
Article: The Whisperings of Ovarian Cancer (early symptoms)
Article: The Truth About CA125
|
GO TO |
Copyright © 2001 by Laura Dolson. All rights reserved. Please submit reprint requests to gyncancer@baymoon.com
The material on this page and Web site is for informational and educational purposes only, and should not substitute for medical advice. Anyone having questions about the application of information appearing here to a specific person or situation should obtain advice from a qualified physician.