WASHINGTON – Congress will decide next year whether to require government health insurance providers to cover osteoporosis testing for patients who are at risk of developing the debilitating bone disease.
Only some of the 400 federal health insurance plans now cover testing for osteoporosis, a disease that results in porous and brittle bones. The National Osteoporosis Foundation estimates that only 15 percent of the 1.04 million over age 50 who now have federal health insurance are covered for bone-mass measurement.
Under a bill by Rep. Constance Morella, R-Montgomery, all federal health insurers would have to cover testing for employees considered at risk of developing osteoporosis.
At-risk groups would include menopausal or estrogen- deficient women, people with spine abnormalities or hyperparathyroidism, those who use certain types of steroids to treat asthma and arthritis and those already being treated for osteoporosis.
The disease results in reduced bone mass, increased skeletal fragility and fracture, according to the National Center for Health Statistics. It affects 28 million Americans, 80 percent of whom are women, at a cost of $13.8 billion each year. Last year, 485,021 men and women had the disease in Maryland.
Osteoporosis occurs without symptoms. Bone-mass measurement, or density testing, is the only reliable way to diagnose osteoporosis and predict risk of fracture, according to the foundation. Tests can also monitor the effects of treatment.
There are two kinds of bone-density tests. A peripheral test of a patient’s foot or wrist costs $30 to $50 and is used to check for low density. If a problem is found, the whole body is scanned at a cost of $180 to $250.
The tests must be ordered by a doctor and require a bone densitometry machine, a low-intensity type of X-ray. Morella’s bill does not specify which tests would be covered, or how often.
Federal insurers contacted for this story declined to comment on the bill.
While it is most prevalent among women, one in three men will develop osteoporosis by age 75. Besides age and gender, other risk factors include a thin, small frame, a family history of the disease, menopause in women, low testosterone in men, an inactive lifestyle and anorexia nervosa or bulimia.
But Morella said risk factors alone cannot predict bone condition and that without bone-density tests, up to 40 percent of women with low bone mass could be missed.
Hip fractures are the most common problem associated with the disease. Half of all women over 50 and one in eight men that age will have an osteoporosis-related fracture in their lifetime, according to the foundation.
While there is no cure for osteoporosis, medication can prevent further bone loss and fractures by increasing bone density. Approved treatments include estrogen and the drugs Alendronate and Calcitonin.
The foundation recommends eating a balanced diet rich in calcium and vitamin D, exercising with weights, refraining from smoking and limiting alcohol to prevent the disease.