QUESTION: I've heard that Medicare now covers Pap smears. Is this true?
ANSWER: Yes. On July 1, 1990, Medicare started paying for Pap smears performed to screen for the early detection of cervical cancer."Medicare coverage of Pap-smear screenings is intended to increase access to this effective method for detecting cervical cancer at a stage when it is more easily treatable," Health and Human Services Secretary Louis W. Sullivan said.
Pap-smear screenings will be covered once every three years, or more often if the patient is at high risk of developing cervical cancer. New regulations will define high risk based on factors such as personal medical history.
"Elderly women are less likely to be screened than younger women, a situation that must be corrected if we are to reduce the incidence of invasive cervical cancer in those 65 and older," said Gail R. Wilensky of the Health Care Financing Administration, which administers the Medicare program.
Medicare expected about 2.9 million claims to be filed under the new benefit in 1990, up from 1 million in 1988. For beneficiaries enrolled in the Part B Medical Insurance Program, Medicare pays 80 percent of the approved charge, after the beneficiary meets the $75 deductible. Medicare previously paid for diagnostic Pap smears only if the patient was treated for an existing gynecological cancer or other disorder, or showed signs of some abnormality.
A February 1990 study by the Congressional Office of Technology Assessment (OTA) found that one-quarter of new cases of invasive cervical cancer occur in women age 65 and older. Only about one-half of elderly women have had a Pap smear within the past three years. At least one out of every four elderly women has never been screened. The OTA found that screening elderly women every three years would save about 21,400 life-years per one million women screened.
The American Cancer Society estimates there will be 13,500 new casesof invasive cervical cancer this year, and 6,000 deaths. Among these, 3,700 cases and 2,500 deaths will occur among women age 65 and older. Over the past 15 years, the incidence of invasive cervical cancer among women age 65 and older has been dropping at an estimated annual rate of about four percent, due largely to increased use of Pap smears, according to the National Cancer Institute.
Send questions about growing older to On Aging, P.O. Box 84256, Los Angeles, Calif. 90073. Questions of general interest will be answered in the column; individual answers cannot be provided.