医疗补助或私人保险是否涵盖癌症筛查？

你知道吗 养成降低癌症风险的生活习惯。 你知道吗 根据你的年龄需要进行的筛查。但是，困难的是如何以可承受的价格进行筛查以及如何办理保险。

保险可能会让人感觉过于复杂和紧张。压力太大了。如果你 由于保险混乱而错过或推迟检查，这里有您需要的信息，这样您就不必将您的健康置于危险之中。

What services are fully covered under Medicaid?

Medicaid coverage for cancer screening tests vary by state. Check with your state Medicaid office to learn more about which cancer screening tests are covered under your plan.

What services are fully covered under private insurance?

这 美国预防服务工作组 (USPSTF)—a group of medical experts who establish recommendations on certain health services, such as cancer screenings—assign a letter grade (A, B, C, D or I) to recommend for or against medical services, based on clinical evidence. Per the Affordable Care Act (ACA), Medicare and private insurers are required to cover services, without cost sharing (including copays or deductibles), that are given an “A” or “B” grade. 您还可以查看 完整的 USPSTF 评分系统 了解每个等级是如何定义的以及这对于覆盖范围意味着什么。

Here is a list of cancer preventive-related services that currently have an “A” or “B” (and are therefore fully covered by Medicare or private insurance):

风险评估/降低

• Risk assessments for women with personal or family histories of breast, ovarian, tubal or peritoneal cancer or who have ancestry associated with BRCA-1 or BRCA-2 gene mutations. After the risk assessment, women with positive risk assessment should receive genetic counseling and, if indicated after counseling, genetic testing.
• 为 35 岁及以上罹患乳腺癌风险较高且副作用风险较低的女性开具降低风险的药物处方。高风险女性可能包括那些有大量癌症家族史（尤其是 50 岁以下罹患癌症的家族成员）、非典型乳腺疾病的个人病史、乳腺密度增加、超重或肥胖以及某些激素和生殖因素。

放映

• Biennial (every other year) breast cancer screening with mammography for women at average risk ages 40-74.
  • Note: The Prevent Cancer Foundation recommends getting routine mammograms every year 从 40 岁开始. The USPSTF recommends only biennial mammograms, but insurance coverage for annual mammograms is protected by congressional action until 2028.
• 针对 21-65 岁平均风险女性进行宫颈癌筛查。
• 针对 45-75 岁平均风险成年人进行结直肠癌筛查。
• 针对高风险青少年和成年人以及孕妇进行乙肝病毒 (HBV) 感染筛查。高风险人群包括出生在或父母出生在 a country outside of the United States with a high prevalence of HBV infection, people who inject drugs, men who have sex with men, people with human immunodeficiency virus (HIV), and the sex partners or household members of people who have HBV infection.
• 针对 18-79 岁成年人进行丙型肝炎病毒感染筛查。
• 50-80 岁患有以下疾病的成年人进行肺癌筛查 20包年吸烟史 目前吸烟或过去 15 年内已戒烟。

咨询和干预

• Skin cancer prevention counseling about minimizing exposure to ultraviolet (UV) radiation for people with fair skin ages 6 months to 24 for young adults, adolescents, children and parents of young children.
• 针对成年人的戒烟干预措施。
• Tobacco use prevention education and counseling for school-aged children and adolescents who have not started using tobacco.
• 针对 18 岁及以上成年人的不健康饮酒筛查和咨询。

Under current law, if you have health insurance and qualify, these preventive services are covered.

阅读完整的服务列表，包括与癌症无关的服务。 建议会定期审查和更新，因此请查看列表以获取最新版本。

那么 USPSTF 不推荐的筛查又如何呢？

The above list highlights routine cancer screenings that must be covered because of the ACA. Private insurers may choose to cover additional services, such as skin cancer checks, prostate cancer screenings or lung cancer screenings for those who quit smoking more than 15 years ago. In addition, screenings that have a “C” grade from the USPSTF may be covered based on your personal or family health history or other risk factors; it’s important to talk to your doctor and check with your insurance plan for more details.

是否存在漏洞？问题出在哪里？

Some insurance plans that were in place prior to the passage of the ACA in 2010 may not offer this coverage. Depending on the state you live in, there may be laws that require private insurance companies and state plans, such as Medicaid, to cover some cancer screening services.

To be certain about your coverage, ask your insurance company how much you should expect to pay before you get a screening. In some cases, the results of a screening could change the cost, so ask about this, too.

如果我不了解我的保险计划该怎么办？

The most helpful action to take may be to call your insurance company. To prepare for the call, have your insurance card or information ready. Take notes during the call and ask clarifying questions, even if it feels like you should already know the answer. You can also call your health care provider’s office for guidance.

如果我没有保险该怎么办？

There are many programs that offer free or low-cost cancer screenings and vaccinations. You can also contact your local hospital or health care facility to ask if they cover routine cancer screening, testing and vaccination through their foundations or outreach programs (including mobile testing).

请记住，早期发现 = 更好的结果。掌控您的健康并立即安排您的常规癌症筛查。