Alzheimer’s blood testing coverage pushed in Maine as thousands go undiagnosed

Maine (WABI) - MAINE — Nearly 27,000 Mainers are living with Alzheimer’s, and as many as half are not formally diagnosed with the disease.

Earlier this year, the Maine Chapter of the Alzheimer’s Association urged state lawmakers to mandate health insurance coverage for biomarker testing. It has been a little more than a year since the FDA approved blood testing to diagnose Alzheimer’s.

“It’s something that can really help us improve the standard of care for Alzheimer’s and bring it into line with other major diseases such as cancer, diabetes, heart disease, where you detect early and you intervene early,” said Jill Carney, Maine public policy director for the Alzheimer’s Association.

Diagnosis delays limit treatment options

According to Carney, it can take two years or longer to receive an Alzheimer’s diagnosis. By that time, it is too late for medications that could slow the progression of the disease.

“Less than 10%, actually, of people with mild cognitive impairment ever receive a diagnosis in this phase,” Carney said.

Blood-based biomarker tests have an accuracy rate of 90-95%. Currently Medicare only covers the FDA-approved screenings for those showing symptoms of the disease, and many private insurers are still making their own determinations.

PET scans and cerebro-spinal fluid are also good biomarkers but they can be timely and only available in certain areas.

Federal legislation seeks expanded coverage

On future tests for screening in individuals with no symptoms, Medicare is prohibited from providing coverage without explicit authority provided by Congress. The federally proposed Alzheimer’s Screening and Prevention Act would provide this authority and pave the way for Medicare to cover screening tests once approved by the FDA for this purpose.

“Also some people under the age of 65, so people not in the Medicare population, may not have any diagnostic test for Alzheimer’s covered,” Carney said.

Currently, blood-based biomarker tests for Alzheimer’s disease are intended for adults aged 55 and older who are experiencing signs of cognitive decline or impairment. Things like misplacing keys are normal. But if someone is struggling to complete daily tasks, confused about time or places, using the wrong name for everyday objects or having trouble retracing steps, doctors recommend discussing the possibility of being tested for Alzheimer’s.

“There is treatment out there that can give you more time, and people really need that. Time is your most critical commodity when you have Alzheimer’s,” Carney said.

Above are the 10 warning signs that you or a loved one could be exhibiting signs of Alzheimer’s disease according go the Alzheimer’s Association. For more information, click here.

Maine’s legislature chose not to fund the state mandate for health insurance coverage during the last session.

Senator Susan Collins helped to introduce the Alzheimer’s Screening and Prevention Act. Collins is the founder and co-chair of the Congressional Task Force on Alzheimer’s Disease.

There could be other causes of memory and cognitive declines including a stroke, Lewy Body, Parkinson’s, depression, sleep disorders, nutritional deficiencies, alcohol and traumatic brain injuries. In some of those cases, Alzheimer’s disease could still be an issue, but as a secondary condition rather than the primary one.