Insurance Coverage

Q

Do insurance plans pay for the HPV test?

A

Most insurance companies provide coverage for HPV testing. In fact, Maryland, Texas, New Mexico, West Virginia, North Carolina and California now require private health insurers in their states to cover HPV testing as recommended by medical guidelines (routinely for women 30 and over, and as a follow-up to an inconclusive Pap for women of all ages). Most states also provide coverage for HPV testing through their Medicaid programs for low-income women.

However, you may still be charged a fee if your policy requires you to pay a deductible before it reimburses for any type of preventive care, or to pay a flat co-fee or percentage of the cost for each test. That's why we recommend that you find out what your policy requires by contacting your insurer.

Note that if you have to pay any portion of the cost for HPV testing, you will be billed directly by the laboratory your doctor or nurse uses to run the test. The cost for the HPV test will not be included in the charges from your doctor's office.



Q

How do you find out what your benefit plan covers for preventive care, and how much you may need to pay?

A

QIAGEN offers a reimbursement hotline that can help you verify what benefits you have and the related requirements. Call 1-866-895-1HPV (1-866-895-1478).

Note that if your benefits plan does not cover HPV testing at all, which is rare, you should also have your doctor or nurse find out for you how much the lab will charge you, since fees vary widely across the country. Remember that if your Pap and HPV results are normal (and they are for most women), you only will need to pay the fee for the HPV test every three years.



Q

Is help available if you don't have insurance coverage and can't afford to get an HPV test?

A

There are many options for obtaining low-cost HPV testing in your area. There are various city, state and federal programs that provide cervical cancer screening to women without health insurance. Many of these, like the Breast and Cervical Cancer Early Detection Program run by the Centers for Disease Control and Prevention (CDC), do not routinely offer HPV testing yet. However, other programs do.

Here are some options that might be available:

  • You can contact the American Cancer Society for a list of local resources in your area: http://www.cancer.org/asp/search/crd/crd_global.asp (type your zip code at the bottom, in the box in the "My Community" section)
  • Planned Parenthood offers gynecologic services, including the HPV test, at rates that are determined by income level.
  • Community or public health clinics may also offer the HPV test at reduced or income-determined rates.
  • You also have the option of asking your gynecologist to refer you to a hospital that offers HPV testing. Many hospitals or hospital clinics offer free or reduced-cost services to patients without health insurance.

For a complete overview of the public health services available in your area, contact your state Department of Public Health and ask to be transferred to the Office of Women’s Health.



Q

What if your health plan does not cover HPV testing or if your claim is denied?

A

If your plan doesn’t cover HPV testing at all, it can help to make your employer aware of your desire for this benefit. Click here (PDF) for a sample letter that you can customize to submit to your Human Resources Department, requesting coverage.

If, on the other hand, you think you are covered but you receive a bill from the lab for the HPV test, call QIAGEN’s reimbursement hotline (1-866-895-1HPV). Our benefit specialists will work with your health plan to determine why your claim was denied and help you submit an appeal if appropriate.