Colonoscopy payment

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.
 
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.
 
Mulligan said:
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.
Click to expand...

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.
 
athena53 said:
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.
Click to expand...

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.
 
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.
 
mpeirce said:
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.
Click to expand...
I had a sig with no anesthesia. The nurse kept saying how well cleaned out I was. I was so proud.
 
travelover said:
I had a sig with no anesthesia. The nurse kept saying how well cleaned out I was. I was so proud.
Click to expand...

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.
 
JoeWras said:
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.
Click to expand...


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


Sent from my iPad using Tapatalk
 
Mulligan said:
Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that. ........
Click to expand...

Not until you wake up.

But seriously, they generally ask that someone accompany you and drive you home.
 
Mulligan said:
Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that.
Click to expand...

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.
 
travelover said:
Not until you wake up.

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


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.


Sent from my iPad using Tapatalk
 
RonBoyd said:
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.
Click to expand...


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.


Sent from my iPad using Tapatalk
 
Mulligan said:
Are you allowed to drive after a procedure with anesthesia?
Click to expand...

Colonoscopies are generally done with either sedation (e.g. Versed) or anesthesia (e.g. Propofol). The effects of Versed take quite a while to wear off, and you are usually told not to drive for 24 hours. Propofol wears off more quickly.

Versed can be adminstered by registered nurses, whereas Propofol requires an qualified anesthetist. Perhaps this is the reason for some of the higher costs reported above?

As well as its calming effect, Versed also inhibits memory, so even if technically you're awake during the procedure, you probably won't remember anything. That would include any discomfort (aka pain!) you felt.

Propofol, on the other hand really does knock you out, so you definitely won't feel anything.
 
d0ug said:
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.
Andy Rooney of 60 minuets was killed by that test and he was in good health but the doctors convinced him to take the test.
Click to expand...

Andy Rooney was 92 years old when he died. I guess a 92 year old might get a colonoscopy, but, I imagine it would be a rare occurrence. And, if no polyps were found and he didn't die, do you think the docs would have recommended he undergo the procedure again in seven years? Anyhow, how did the colonoscopy actually kill him? I couldn't find any information on this, but then, again, others have found my research skills to be lacking.
 
I'd looked up Andy Rooney's death, too, and found only that he died from complications of "a minor surgical procedure". DH is 76 and has been told not to bother getting colonoscopies anymore due to his age, but a former work colleague of his was getting them every 6 months or so when he was in his late 70s because apparently he developed polyps that fast. I think they've stopped those now; he's in his early 80s and too frail to go through it all. I'd be really surprised if Andy Rooney had one although my 95-year old grandfather had to fight off surgeons who wanted to operate on him for colon cancer. I guess as long as Medicare is paying...
 
I believe Andy Rooney's death was announced by one source at the time as being due to an appendectomy. A simple "In by 9:00/out by 5:00" procedure for most people but at age 92 everything is risky.
 
Mulligan said:
Are you allowed to drive after a procedure with anesthesia? I hadn't thought of that.
Click to expand...

I remember once walking out of the hospital after anesthesia and having to look down - I couldn't remember putting on my pants and wasn't sure I was wearing any!

That put me on notice. I felt fine, everything working well, but if I was that mentally unaware I certainly had no business driving a car. DW drove and I spent the rest of the day home.
 
Walt34 said:
I remember once walking out of the hospital after anesthesia and having to look down - I couldn't remember putting on my pants and wasn't sure I was wearing any!

That put me on notice. I felt fine, everything working well, but if I was that mentally unaware I certainly had no business driving a car. DW drove and I spent the rest of the day home.
Click to expand...


When I had my only anesthesia concerning a knee scope, I remember thinking right before the injection, that I'm am going to fight it and see how long I can stay awake. I then asked the nurse or attendant when the procedure would begin and she told me it was already completed. I guess I wasn't very good at fighting it off! When leaving I wasn't mentally unaware in anyways, though I felt like crap for several hours.


Sent from my iPad using Tapatalk
 
Last edited by a moderator:
You must log in or register to reply here.

Similar threads

audreyh1
Medicare and Colonoscopy: some surprises.
2
Replies
40
Views
4K
RetMD21
R
N
How To Find Low Cost Lab For Annual Blood Work?
2 3
Replies
52
Views
2K
athena53
athena53
folivier
VIA Disc NP Allograft for spine?
Replies
1
Views
160
BruinBones
BruinBones
REWahoo
Programming a replacement Remote Key Entry fob
2
Replies
25
Views
531
Sunset
Sunset
folivier
Colonoscopy, which prep?
2 3
Replies
56
Views
5K
Route246
R

Latest posts

Back
Top Bottom