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Old 08-14-2014, 10:56 AM   #21
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Thanks for this topic. I'm due for a 5-year check next year and this will be my first time with a private HDHP; good to know what to expect and what questions to ask. I'm happy to see that my doc and the hospital I used in the past are in network, but with a couple of (benign) polyps in my history, I'm going to check on costs and coverage.



I did the Fecal Occult Blood Test a few months ago just to get an indication as to whether there might be problems developing. It was negative, so that was happy news. (I'm not a doctor but my understanding is that it's just that- an indication. A positive result was what motivated me to get my first colonoscopy and I did have a polyp that was removed.)

The MRI procedure (again, my non-expert understanding) may find polyps but (1) you still need to do the same prep, which for most people is the worst part and (2) if they find anything you need to go back for a regular colonoscopy to get it removed.
opps, VERY poorly stated. The MRI was not for polyps. I was simply surprised there was an alternative MRI and was simply trying to communicate that maybe there is an alternative colonoscopy exam, like there is an alternative MRI. When I saw the $950 cost vs. the $3000 I paid is a considerable savings.

As for going back for a colonoscopy after they have found polyps, it will not be covered by insurance unless you have an unusual policy. Once you are viewed as a risk (polyps found), you no longer fall under preventative, sometimes free examination. Seems backwards to me but that is the lesson I learned the hard way.
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Old 08-14-2014, 11:51 AM   #22
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If you look-up procedure costs to US patients vs other modern medicine countries, it turns out colonoscopy is "only" double (mosty other procedures are 5 times more expensive in the US).

My former insurer, Aetna, had a procedure/price lookup that was somewhat useful. I learned that in general, if you go to a place that does nothing but colonoscopies, the price is much cheaper than going to a hospital for one.

Propofol is the "new thing" in anesthesia, but BCBS says it's not typically medically necessary. My GI's office said that they couldn't talk details of anesthesia, so I said "you subcontract to these guys and you don't know what they charge?" That went nowhere. But I did get the name of the anesthesia outfit and I got a price out of them: $100. When the bill came (denied by BCBS) it was $300. I wrote 'em a letter and said they'd not get paid anything unless I got agreement that $100 was payment in full. That worked! Record all of your telephone conversations with these guys!
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Old 08-14-2014, 12:24 PM   #23
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I would never have a colonoscopy test because you can go to the drug store and get a FIT [ fecal immunochemical test] test which is about $5 and give you nearly the same information and if worried get a ultrasound.
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This isn't entirely accurate. The fecal blood test looks at your poop for blood. If blood is found, what do you think they do? They send you for either a sigmoidascopy or a colonoscopy.

I flunked the fecal blood occult test and had my first full procedure at age 41. They had me do a sigmoidoscopic procedure - but they found 3 polyps - and two were bigger than could be removed with the sigmoidascope... so I had to repeat with the full colonoscopy.

I feel lucky to have had the polyps discovered and removed. They were considered pre-cancerous. This is a reminder that you should pay attention to blood in the stool. I thought the blood was possibly a sign of hemorrhoids since I'd had my younger son a few months earlier and hemorrhoids and pregnancy/birth can go hand in hand.
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Old 08-14-2014, 02:00 PM   #24
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Fecal blood test being positive could definitely be caused by hemorrhoids or an anal fissure. Also, if its negative, it doesn't necessarily mean polyps aren't present.
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Old 08-14-2014, 02:09 PM   #25
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Propofol is the "new thing" in anesthesia, but BCBS says it's not typically medically necessary. My GI's office said that they couldn't talk details of anesthesia, so I said "you subcontract to these guys and you don't know what they charge?" That went nowhere. But I did get the name of the anesthesia outfit and I got a price out of them: $100. When the bill came (denied by BCBS) it was $300. I wrote 'em a letter and said they'd not get paid anything unless I got agreement that $100 was payment in full. That worked! Record all of your telephone conversations with these guys!
I hope this isn't TMI, but I've had both of my previous colonoscopies done without anaesthesia. (My mother does the same thing.) If you're female and have had bad menstrual cramps, it's not much worse than that for a normal colon (i.e. one with no weird adhesions or a lot of twists and turns). There's no pain when polyps are removed. I found it pretty interesting to watch. Bonus: you're not groggy afterwards and can go home earlier. I even went out for a run later in the day. Don't tell my doctor.

It's one of the things I plan to ask about when I check costs, but I'll probably have to fight them having an anaesthesiologist there "just in case". I think they've done that before.
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Old 08-14-2014, 02:40 PM   #26
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Is this procedure covered under Medicare and TFL? I have not had it done while on Medicare/TFL and assumed that it would be fully covered like everything else. Anyone else had any experience while on Medicare? I'm at about the 5 year mark now and should be getting it redone soon.
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Old 08-14-2014, 02:44 PM   #27
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Not sure about TFL, but it is covered under Medicare.
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Old 08-14-2014, 02:51 PM   #28
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It should be. When I had my last one (2009) it was covered by Tricare Standard.
I'm on a 7-year schedule, so I have a while to go yet.
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Old 08-14-2014, 03:00 PM   #29
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Not sure about TFL, but it is covered under Medicare.
Polyp removal will be covered by any supplemental coverage.
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Old 08-14-2014, 04:29 PM   #30
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For example, when a polyp is found, insurers are now charging the patient for the next colonoscopy, arguing that the patient is no longer symptom-free and the colonoscopy has become a "diagnostic" or "surveillance" procedure.
Sure, I understand that. I've seen that with some other things on my HDHP.

However, for whatever reason, my HDHP covered my follow-up scoping just ONE year later. The GI office called ahead to the insurer to make sure it was covered. I normally have to pay for everything except my once a year routine physical, and the once per 10 years after 50 scope.

I do believe this is the exception rather than the rule.

Perhaps it helps that my procedure is in the $2500 range (including the polyectomy, biopsy and anethesia) instead of some of the crazy rates others above have reported.
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Old 08-14-2014, 09:07 PM   #31
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I hope this isn't TMI, but I've had both of my previous colonoscopies done without anaesthesia. (My mother does the same thing.) If you're female and have had bad menstrual cramps, it's not much worse than that for a normal colon (i.e. one with no weird adhesions or a lot of twists and turns). There's no pain when polyps are removed. I found it pretty interesting to watch. Bonus: you're not groggy afterwards and can go home earlier. I even went out for a run later in the day. Don't tell my doctor.
I had an endoscopy without any anesthetic and it was pretty interesting too. The Doc showed me everything as he was doing the imaging.

He liked the idea, but the nurse thought I was nuts. With no sedation at all, I was able to drive home by myself too.

When I get around to having a colonoscopy, I'll definitely ask about doing it this was too.
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Old 08-14-2014, 09:21 PM   #32
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After reading all of this I am so thankful that I was insured by GEHA for my first and am covered by Kaiser NW's Medicare Advantage plan at present. They have recommended a follow-up colonoscopy.
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Old 08-15-2014, 08:07 AM   #33
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I had an endoscopy without any anesthetic and it was pretty interesting too. The Doc showed me everything as he was doing the imaging.

He liked the idea, but the nurse thought I was nuts. With no sedation at all, I was able to drive home by myself too.

When I get around to having a colonoscopy, I'll definitely ask about doing it this was too.
I had a sig with no anesthesia. The nurse kept saying how well cleaned out I was. I was so proud.
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Old 08-15-2014, 08:19 AM   #34
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I had a sig with no anesthesia. The nurse kept saying how well cleaned out I was. I was so proud.
I didn't see it, but my GI doc gave me pictures.

They used Propofol. That stuff is incredible magic. I was 90% for the hour afterward, and then 100% the rest of the day, although I didn't drive just to be sure.
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Old 08-15-2014, 08:26 AM   #35
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I had a sig with no anesthesia. The nurse kept saying how well cleaned out I was. I was so proud.
I just laughed out loud at this......thank you.
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Old 08-15-2014, 09:48 AM   #36
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I didn't see it, but my GI doc gave me pictures.

They used Propofol. That stuff is incredible magic. I was 90% for the hour afterward, and then 100% the rest of the day, although I didn't drive just to be sure.

Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that.


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Old 08-15-2014, 09:51 AM   #37
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Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that. ........
Not until you wake up.

But seriously, they generally ask that someone accompany you and drive you home.
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Old 08-15-2014, 09:53 AM   #38
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Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that.
No. And everywhere I have been has required that the designated driver be there with you physically at the time of check-in -- and he or she cannot be a commercial driver, i.e., taxi, bus, etc.
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Old 08-15-2014, 09:55 AM   #39
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Not until you wake up.

But seriously, they generally ask that someone accompany you and drive you home.

The only time I have ever had anesthesia was for a knee scope and they absolutely were not going to let me leave without someone taking me and not driving. I didn't know if the colonoscopy entailed a "knockout" anesthesia or a local one was administered. I don't know about the doing it without any as a few here have done. I guess I would if that allowed me to drive.


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Old 08-15-2014, 09:59 AM   #40
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No. And everywhere I have been has required that the designated driver be there with you physically at the time of check-in -- and he or she cannot be a commercial driver, i.e., taxi, bus, etc.

So much for the taxi man driving you around the block trip, huh? That would have been my plan. I wonder if it is a law, as I was warned before hand to bring someone and I guess I gave her the "whatever" attitude and she sensed I was going to do it on my own. She said I wouldn't be released without someone there with me.


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