September is Prostate Cancer Awareness Month

BY IRENE CARD AND BETSY CHANDLER

NEWJERSEYNEWSROOM.COM

YOUR HEALTH INSURANCE

While most of us would like to be content in our own little cocoon and believe that cancer is something that happens to someone else, the reality is far from that. Generally speaking, most men will do anything to avoid a visit to a physician. They have to be in a lot of pain before they will make an appointment. Married men have an advantage because their wives will insist that they get there routine cancer screening tests.

Prostate cancer is the second leading killer (behind lung cancer) among men in the USA. 192,000 new cases are expected in 2009 along. Early detection and treatment are key factors in addressing prostate cancer. The sentence you just read is so very important that I encourage you to read it again. "Early detection and treatment are key factors in addressing prostate cancer". No one knows the exact cause of prostate cancer. Doctors can seldom explain why one man develops the disease and another does not. Research has shown that men with certain risk factors are more likely than others to develop prostate cancer. A risk factor is something that may increase the chance of developing a disease. Age is the strongest risk factor for prostate cancer. The disease is rare in men younger than 45, but the chance of getting it goes up sharply as a man ages.

A man's risk of prostate cancer is higher than average if his brother or father had the disease.

I have a client who told her husband that she would not get another mammogram until he had a prostate cancer screening test. Needless to say, this erupted into a major argument between the two of them but it worked! He scheduled an appointment and she had her mammogram. His PSA blood test was borderline and they continue to watch him very closely. The earlier it is detected the greater your chances of conquering this disease.

There simply is no excuse for men to not get a yearly prostate cancer screening test. Most group and individual health insurance plans have a "routine" benefit of up to $500 per calendar year. This can include a routine physical, a mammogram, a prostate cancer screening and even a flu shot. However, if your plan has a limit of $500, keep track of the costs. A routine physical with chest x-ray, an EKG and whatever other tests your physician wants to include can cost well over $500. If the primary diagnosis is ‘routine healthy male or female' and there is no secondary diagnosis, you will pay for all costs after the $500 benefit. If there is a secondary diagnosis, insurance will pay according to the terms of your insurance contract, after the first $500.

If you are on Medicare, Medicare covers the digital rectal exam at 80 percent (if you have a Medigap policy, it will pay the remaining 20 percent) and the PSA (Prostate Specific Antigen) blood test every 12 months. There is no cost to you for this blood test but if you repeat the test in less than 12 months, you will pay for the entire cost out of your pocket so keep track of the dates of your routine exams. A medical file folder is a must for everyone. You can keep track of the dates on the inside of the cover of the file folders. Women should do the same for their mammogram tests because Medicare will only pay once every 12 months as will most insurance plans if you are under the age of 65.

If you do not have health insurance and you cannot afford the screening exam and blood test, there are organizations that will either provide the test at no charge or help you with paying for the exam. ZERO is a national organization known as the Project to End Prostate Cancer. They have a mobile screening program for free prostate cancer screening. This huge, mobile van travels throughout the country. They offer many programs to raise awareness of prostate cancer. You may find their web site interesting. It is www.zerocancer.org. Another valuable resource is the web site for US TOO, a non-profit prostate cancer support group that has chapters throughout the country. I usually present a program on health insurance issues once a year at the chapter that meets in Morristown Memorial Hospital. The web site is www.ustoo.org. You can find a chapter near you by going to their web site.

Irene Card & Betsy Chandler are both licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.