Resources for insurance coverage

Share this page

We understand that dealing with insurance coverage can be difficult, and that things may be different for your cost coverage for anal HSIL screening and treatment outside of the ANCHOR study. Because these procedures help prevent anal cancer, they are recommended for your medical care. To help encourage coverage of these important procedures, we are sharing a resource for challenging insurance coverage for anal HSIL and cancer screening procedures.

Please find below links for template letters to send to your insurer with instructions and references if you are facing a coverage denial. These materials are based on resources and a guide from the Patient Advocate Foundation, and are pre-populated for situations involving anal HSIL screening and treatment for anal cancer prevention, for you to modify and use as needed. Templates are available for the following coverage issues. Choose the one(s) that best match the denial reason on your insurer’s Explanation of Benefits. 

In either case, we recommend asking your healthcare provider for a letter of medical necessity, and including it with your letter. This template for your healthcare provider is provided below.

These resources are available to anyone to use. The specific process to follow depends on your insurer, so please follow their instructions carefully. See the following brochure from the Patient Advocate Foundation for more information that may help you navigate the insurance appeals process:

If you need copies of any of the publications referenced in the letter(s), see the following links provided below, as included in the letter templates:

Clifford GM, Georges D, Shiels MS, et al. A meta-analysis of anal cancer incidence by risk group: toward a unified anal cancer risk scale. Int J Cancer. 2021; 148: 38-47.

Damgacioglu H, Lin YY, Ortiz AP, Wu CF, Shahmoradi Z, Shyu SS, Li R, Nyitray AG, Sigel K, Clifford GM, Jay N, Lopez VC, Barnell GM, Chiao EY, Stier EA, Ortiz-Ortiz KJ, Ramos-Cartagena JM, Sonawane K, Deshmukh AA. State Variation in Squamous Cell Carcinoma of the Anus Incidence and Mortality, and Association With HIV/AIDS and Smoking in the United States. J Clin Oncol. 2023 Feb 20;41(6):1228-1238. doi: 10.1200/JCO.22.01390. Epub 2022 Nov 28. PMID: 36441987; PMCID: PMC9937095.

Palefsky JM, Lee JY, Jay N, Goldstone SE, Darragh TM, Dunlevy HA, Rosa-Cunha I, Arons A, Pugliese JC, Vena D, Sparano JA, Wilkin TJ, et al. Treatment of Anal High-Grade Squamous Intraepithelial Lesions to Prevent Anal Cancer. N Engl J Med 2022;386: 2273-82.

Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. 2024. Available at Section on Human Papillomavirus Disease.

Stier EA, Abbasi W, Agyemang AF, Valle Álvarez EA, Chiao EY, Deshmukh AA. Brief Report: Recurrence of Anal High-Grade Squamous Intraepithelial Lesions Among Women Living With HIV. J Acquir Immune Defic Syndr. 2020 May 1;84(1):66-69. doi: 10.1097/QAI.0000000000002304. PMID: 31977596; PMCID: PMC7138737.

Stier EA, Clarke MA, Deshmukh AA, et al. International Anal Neoplasia Society's consensus guidelines for anal cancer screening. Int J Cancer. 2024; 1-9. doi:10.1002/ijc.34850.  Epub 2024 Jan 31. PMID: 38297406.

Wu CF, Xu L, Fu S, Peng HL, Messick CA, Lairson DR. Health Care Costs of Anal Cancer in a Commercially Insured Population in the United States. J Manag Care Spec Pharm. 2018 Nov;24(11):1156-1164. doi: 10.18553/jmcp.2018.24.11.1156. PMID: 30362917; PMCID: PMC10397580.