Representatives of Blue Cross and Blue Shield of Maryland said yesterday that they were studying a call by their national zTC parent group to cover routine testing for such diseases as cancer and heart disease but that cost may remain an impediment.
On Tuesday, the Chicago-based Blue Cross and Blue Shield Association issued guidelines suggesting that the 73 independent organizations around the country offer customers a range of preventive health screenings. The guidelines can be accepted, rejected or modified by the local Blue Cross organizations.
Rita Costello, director of group marketing for Maryland's largest health insurer, said that Blue Cross and Blue Shield began marketing prevention-based packages to all its group plans five years ago.
But in an era when employers are looking for ways to contain rising premiums, 90 percent of the companies offering Blue Cross policies havedecided not to offer the extra coverage to their members. Instead, employers have opted for leaner policies that cover treatments for illnesses but not routine tests aimed at detecting silent but potentially lethal diseases in their early stages.
"While employers seem interested in these benefits, the problem comes to focus when they look at the total cost of the health care package," Ms. Costello said. Blue Cross, she said, offers a variety of plans to employers, but companies may opt for spare or generous packages depending on the premiums they wish to incur or pass on to their employees.
The guidelines released Tuesday suggest a schedule of routine tests -- including Pap smears for cervical cancer, mammograms for breast cancer, cholesterol testing for heart disease, and sigmoidoscopies and stool tests for colon-rectal cancer. Flu shots and tetanus-diphtheria boosters would also be covered.
All tests and shots would be given at different intervals in a person'slife. For instance, Pap smears would be covered every three years beginning at age 20, or every one to two years for women deemed to be at high risk for the disease.
The coverage would mean an added monthly premium of about $7.50 for a family whose insurance coverage now costs $200 to $300 a month, according to an account in yesterday's New York Times.
Yesterday, Ms. Costello said she couldn't say yet how the recommended coverage compares to plans already offered in Maryland. But one package in Maryland that offers physicals and screenings for heart disease, diabetes, thyroid disorders and colon cancer costs an extra $12 a month for families, she said.
Ms. Costello said she had no idea how the national organization arrived at a $7.50 monthly add-on. "I've never seen costs that low for any of these programs," she said, adding that the figure may be based on coverage that's less generous than the packages offered here.