Sticky insurance situation - Women's Health Message Board

MusicElle · 09-16-2007, 01:50 PM

hi this is my delema, Im a 21 yr old married woman and I was considering getting the gardsil vaccine. The problem is my insurance will not cover it because of my age and my married status. They say that I would have no benifit from it because I if i have been exposed to HPV through my husband it is too late for the vaccine to do any good and Im married so I wont be exposed to the virus though someone else. Out of pocket the vaccine will cost me about $500 including the doctors visits. Now Im debating getting the vaccine if I have to pay. My doc says that every woman can benifit from the vaccine but after reading the letter from the insurance company Im starting to think its not worth my money. What do you guys think? Is it worth the money? (I also should mention that I am not sure my doctor realizes Im married because I have had to remind them to note it on my record several times so maybe she suggested the vaccine thinking I am single.)

Thisby · 09-16-2007, 05:30 PM

Since (in theory) you have already been exposed to all the strains of HPV you're going to be exposed to through either your or your husband's previous partners, the vaccine would do you no good at all - zero. The benefit is solely against what you may be exposed to in the future (and even then, only against the 4 most common strains, 2 for cancer, 2 for warts). Since you are married, their logic is that you won't be exposed to any new strains, and what you already have you already have, therefore: no benefit from vaccine, no reason to pay for something with no benefit.

And generally, this is sound logic.

What benefit does your doctor see for you? The implication is that one of you is going to cheat (how else would you get exposure?). I'd ask for specific reasons your doc says you'd benefit. I'm more inclined to think you doc thinks you're single... I'd definitely say get it even if you have to pay for it yourself if you're a single woman, but not if you're married...

MusicElle · 09-16-2007, 09:01 PM

Thanks for the input Im going to have to call the doctor again and make sure she truley understands the situation, I just got married recently and Im young to be married (it also dosent help that I look more like Im 16 than 21) So it could just be her thinking Im single. I don't think that its worth the $500 but I just wanted some opinions maybe someone would know something I didn't.Thanks

jen52983 · 09-17-2007, 01:38 PM

Insurance companies are idiots.. that or my doctor is. My bet is on the insurance company.

After a conversation with my Gyno about HPV and all the different types, you can still be at risk for other types even if you've already been exposed. B/c of the different levels of HPV, if you have the lowest form, for example, the vaccine can still help with any higher form of the virus. At least this is my understanding based on the conversation.

Also.. and I do not mean to offend you with what I'm about to say.. just throwing out a hypothetical situation that proves the insurance company's stupidity... they're assuming that you and your husband will always remain faithful (which you will.. like i said, just a hypothetical situation) or that, God forbid, no physical harm will ever come to either of you. Slim chance.. but still, it shouldn't be the insurance company's chance to take.

If I were you, I'd talk to your doctor about HVP and the vaccine. And get back on the phone with the insurance company!

MusicElle · 09-18-2007, 11:55 AM

well I got on the phone with my doctor she seems to think that I will be ok with out the vaccine. Me and my husband were virgins when we met so there is a low risk of hpv with us. She was under the impression that I was single when she suggested the vaccine and she seems to think there is no way to get my insurance to pay. So I am going to go with out it I just don't have the money, maybe once I finish my degree I can afford it but for now I think I'll be ok with out it.