STD screening

[Deleted]

I wanted to do this after my divorce just for peace of mind and to have a "clean slate".  I didn't have any reason to think anything, no symptoms, etc just wanted the peace of mind.

But I was told insurance will only cover if you have symptoms and otherwise the prices were crazy high for each thing to be tested.

When is the last time you had a screening and what does it typically cover?  I'm tempted to go back and say I'm having symptoms.

Should I just go to Planned Parenthood or something?

[redredwine]

I think my regular pap was able to screen for some things then it was maybe $120 out of pocket (after deductible) for the rest (blood/lab test). Totally worth it.

[formerlyak]

When I went through my divorce, my doctor was able to write it up so that insurance covered it somehow. And they did it twice. Once right away and once 6 months later, since things like HIV can sometimes take that long to appear in blood test results. Can you talk to your doctor about it?

[calle28]

I get mine done during my annual physical. Luckily all I have to pay is my $20 copay.

[alleinesein]

Do you have a local health clinic? They typically offer STD tests on a sliding scale. Otherwise check with PP. If you do have a PAP with an HPV test be aware that you can get a false positive reading on the test. A colposcopy with a biopsy will give you more accurate results for HPV.

[sweetchix]

I just went to my gyno in August, specifically for STD testing and only paid my copay of $50. I haven't done the blood work yet, but I've donated blood twice in the last 4 months and they test for the same things, so it's like a free blood test.

[1confused1]

I would have paid any amount for the peace of mind.

[Deleted]

Sept 29, 2015 16:17:13 GMT -5 alleinesein said:

Do you have a local health clinic? They typically offer STD tests on a sliding scale. Otherwise check with PP. If you do have a PAP with an HPV test be aware that you can get a false positive reading on the test. A colposcopy with a biopsy will give you more accurate results for HPV.

HPV itself is detected using molecular testing. A colposcopy is essentially just magnification of the cervix. It doesn't detect HPV. You might be able to see cellular changes, but it's not the most sensitive or specific test for HPV.

To detect HPV accurately you don't need a colpo and biopsy.

OP, did you talk directly with your insurance company?

Obviously I don't know everything about insurance but that's really odd that it wouldn't be covered as there are recommendations to screen for gonorrhea and chlamydia and HIV yearly (between ages of 20-65 I believe but don't quote me on the ages), since you are very likely to not have symptoms with those. And insurance typically follows recommendations for preventative health care. (Typically the recommendation for HPV screening is to start after age 30 as younger women clear it so testing isn't recommended by ACOG until 30, just pap every 3 years if it's normal).

The majority of patients that I see have government health insurance and we test everyone yearly and it's always covered.

I would definitely call your insurance back to get clarification. If not, if your area has a clinic at the health department or planned parenthood, I'm sure the price would be a little less. Definitely worth the peace of mind!

[alleinesein]

Sept 29, 2015 17:10:03 GMT -5 @wandering said:

Sept 29, 2015 16:17:13 GMT -5 alleinesein said:

Do you have a local health clinic? They typically offer STD tests on a sliding scale. Otherwise check with PP. If you do have a PAP with an HPV test be aware that you can get a false positive reading on the test. A colposcopy with a biopsy will give you more accurate results for HPV.

HPV itself is detected using molecular testing. A colposcopy is essentially just magnification of the cervix. It doesn't detect HPV. You might be able to see cellular changes, but it's not the most sensitive or specific test for HPV.

To detect HPV accurately you don't need a colpo and biopsy.

I'm going based off of my experience and the information given to me by my Gyno.  I had to go through all of those fun tests this month because of a false positive on the standard HPV test.  Since the standard test cannot determine if there are warts present he wanted to do the colposcopy to see if there was anything growing on or near the cervix.  He did the biopsy to test for HPV 16 and 18.  That was also in addition to the standard PAP plus he took additional swabs of my cervix and various areas along the vaginal canal.  All of those tests came back negative for HPV.  

[MyName]

They always ask me if I want an STD screen with my annual gyn exam, and it's been covered by insurance.

ETA:  But YES, if your insurance is outrageous, this is exactly what PP is for - go there.  The only medical appts I ever made in my 20's were at PP, for my annual and to get BC.  

[Deleted]

Sept 29, 2015 17:36:19 GMT -5 alleinesein said:

Sept 29, 2015 17:10:03 GMT -5 @wandering said:

HPV itself is detected using molecular testing. A colposcopy is essentially just magnification of the cervix. It doesn't detect HPV. You might be able to see cellular changes, but it's not the most sensitive or specific test for HPV.

To detect HPV accurately you don't need a colpo and biopsy.

I'm going based off of my experience and the information given to me by my Gyno.  I had to go through all of those fun tests this month because of a false positive on the standard HPV test.  Since the standard test cannot determine if there are warts present he wanted to do the colposcopy to see if there was anything growing on or near the cervix.  He did the biopsy to test for HPV 16 and 18.  That was also in addition to the standard PAP plus he took additional swabs of my cervix and various areas along the vaginal canal.  All of those tests came back negative for HPV.  

Got it! It can all be somewhat confusing and technical.

Pap, colpo, biopsy and HPV testing are all 4 separate things, but obviously overlap. Pap is looking at certain cellular changes, same with the biopsy, while HPV is a separate swab and the HPV is identified by DNA testing. The pap looks for cellular changes and then if those cellular changes are present (depending on what they are) you can test specifically for HPV using DNA testing. It can definitely be difficult to explain and then keep all the details straight. If you simply want to test for HPV you just need to do cervical swab, no need for a pap, colpo or biopsy. I know sometimes women get confused and think using a speculum = a pap smear, but I try to explain that that's not always the case, the speculum just makes it easy to visualize the cervix to swab it. 

I just didn't want OP going in demanding a colpo and biopsy for STI screening as that's a completely unnecessary first step in screening. Glad all your tests came back negative, I know the waiting can be stressful...been there, done that!

[brooke77]

I always get HPV, clymidia and ghonorhea (I'm so sorry for my horrible spelling but I'm afraid to google at work) at my annual. It is covered, but I have to consent. I also opt to get HIV, which is extra but inexpensive. I believe those are covered because they typically are asymptomatic but can cause issues (infertility, etc) if not treated. HIV, I get tested for obvious reasons.

[glynn]

I had mine done with physical. My physical was scheduled when it was all pretty new so the nurse asked and I told her to sign me up for everything.

[Deleted]

Ok I will see if I can just add it into my annual physical coming up; hopefully they can screen most with blood/urine. Otherwise I guess I'll get the others with my gyn visit next year. The place I went was a random walk-in clinic that advertises for screenings. I liked the idea of not going to my normal doctors for this. I guess I just worry too much about judgement etc especially if something comes back positive.

Thanks for all advice.

[Deleted]

@blushnbashful the fact that it was a random clinic was probably why it wasn't covered by insurance. Also doctor's see this everyday. I can promise you there is no judgement. They are just there to help you and make you healthy again. If you do feel like they are judgey, then it's time to switch doctors.

[Deleted]

Do you think most people are pretty blase about STDs these days? Random sex just seems so rampant and at such an earlier age now I wonder how many truly 100% of the time use condoms or abstain. OR require a screening before sleeping with someone. I'm guessing the % is low especially when seeing stats like below.

Being back in the dating scene gives me a headache and anxiety.

www.ashasexualhealth.org/stdsstis/statistics/

[jigsy]

I'll own up to making some pretty stupid choices about doing what I needed to do to be healthy IRT my sexuality. I don't think doctors are blase per se, but I don't think they judge it either. And like PDX said, if you get judgement, it's time for a new doctor.

[Deleted]

Follow up...

Went for my annual physical and they did a full screening (well, all the ones that blood work picks up) - as far as I know insurance will cover it all, I didn't have to pay anything on the spot anyway. When I see my gyno next year I'll ask her to screen the others.

Like y'all said, it wasn't weird at all - I told her about my divorce and wanting an STD screening and she was totally cool about it.

Someone on another board posted this article recently - def helps give me peace of mind while I await results:
markmanson.net/std-guide