Preventative Colonoscopy Shock

[Rianne]

My DH, 60 yrs old, signed up for a colonoscopy. Since it's a preventative there's no cost to us, or so we thought. I started reading articles where people had the preventative colonoscopy. They found benign polyps and were charged for diagnostic colonoscopy, big difference!

I prefer Cologuard and feel if there's an issue, I'll proceed with a diagnostic colonoscopy. And I'll get a Cologuard every 3 years as suggested. DH thought he'd go the surgical route as they are so common and are covered by ACA rules.

I called the hospital medical coding department and asked to explain what happens if there's a benign polyp or two. Always thought they just snip them and you're done. I realize they have to biopsy them, but how much can that cost? Uhhh, thousands! Dh cancelled his colonoscopy and requested Cologuard. The nurse said, no problem, many people were going that route.

 

[GrayHare]

Be aware Cologuard is not a colonoscopy substitute since it will not detect polyps but rather only active cancer cells.

 

[Rianne]

Yes, but there are parts of the colon that do not show up in a colonoscopy. Flat cancers and parts the equipment does not reach. Cologuard gets all the "shedded cells" and may detect colon cancer where the colonoscopy did not. I wrestled with my decision. I hate anesthesia, and would need the deep sleep according to the nurse. Plus, I considered there is always a risk, no matter how simple a surgery may be. My neighbor died on the operating table for a very simple procedure that was never fully explained to his wife, my friend.

 

[Texas Proud]

When I went in for my colonoscopy they were telling me that I would have to pay if blah, blah, blah....


I told them I would not pay for anything as I have read that IF they code it right then it is still free and you only have to pay for the stuff that is not free...

I had at least one polyp removed (maybe 2) and did not get charged a thing...

 

[HadEnuff]

My DH, 60 yrs old, signed up for a colonoscopy. Since it's a preventative there's no cost to us, or so we thought. I started reading articles where people had the preventative colonoscopy. They found benign polyps and were charged for diagnostic colonoscopy, big difference!

I prefer Cologuard and feel if there's an issue, I'll proceed with a diagnostic colonoscopy. And I'll get a Cologuard every 3 years as suggested. DH thought he'd go the surgical route as they are so common and are covered by ACA rules.

I called the hospital medical coding department and asked to explain what happens if there's a benign polyp or two. Always thought they just snip them and you're done. I realize they have to biopsy them, but how much can that cost? Uhhh, thousands! Dh cancelled his colonoscopy and requested Cologuard. The nurse said, no problem, many people were going that route.

I am confused by your post. I have an ACA policy in NY State. I had my regularly scheduled colonoscopy (Rx'd every 5 years; no hx of cancer but positive for benign polyps), they found a new polyp which they excised.
I never got a bill for anything.

 

[foxfirev5]

When I went in for my colonoscopy they were telling me that I would have to pay if blah, blah, blah....


I told them I would not pay for anything as I have read that IF they code it right then it is still free and you only have to pay for the stuff that is not free...

I had at least one polyp removed (maybe 2) and did not get charged a thing...

+1 Same results here for both DW and I. No charge. Also, I would not go to a hospital or Dr billing dept to get an estimate of charges. In my experience it is a waste of time. If they are in network the charges are a fraction of what they wish you would pay.

 

[audreyh1]

Yep no billing for DH either except for Dr visit under ACA as he had a polyp removed and analyzed.

 

[braumeister]

I'm a little confused too (no smart remarks, please!).

I've had three colonoscopies, and the first and third both found and removed benign polyps. Haven't had to pay for anything yet. My supplemental picked up the difference, but Medicare paid the bulk of the bills.

 

[Dtail]

Yes, but there are parts of the colon that do not show up in a colonoscopy. Flat cancers and parts the equipment does not reach. Cologuard gets all the "shedded cells" and may detect colon cancer where the colonoscopy did not. I wrestled with my decision. I hate anesthesia, and would need the deep sleep according to the nurse. Plus, I considered there is always a risk, no matter how simple a surgery may be. My neighbor died on the operating table for a very simple procedure that was never fully explained to his wife, my friend.

Best 1 hour nap you will ever have. The colonoscopy is more thorough for what has been explained to me and many others.

 

[SumDay]

Cologuard wasn't covered by my insurance. Glad I checked before I used it.

 

[Dawg52]

Best 1 hour nap you will ever have. The colonoscopy is more thorough for what has been explained to me and many others.

First one I had put me down for the count. My 2nd one(last month) just put me in a very relaxed state. I could see the screen of my colon as the procedure was done. But he could have cut off half of my colon and i wouldn't have felt it.

If Cologuard is paid for by Medicare 10 years from now, I may opt for that. Haven't had any polyps to this point and no family history of colon cancer.

 

[Big_Hitter]

are you willing to risk your health for a few grand? smh

 

[Dtail]

First one I had put me down for the count. My 2nd one(last month) just put me in a very relaxed state. I could see the screen of my colon as the procedure was done. But he could have cut off half of my colon and i wouldn't have felt it.

If Cologuard is paid for by Medicare 10 years from now, I may opt for that. Haven't had any polyps to this point and no family history of colon cancer.

Down for the count both times. 1 polyp each time, but benign. Will continue to go every 5 years.
One of the most preventable cancers. Some guys being scared of the procedure is kind of ridiculous. You wouldn't even know it happened.

 

[HadEnuff]

my last three I did without any drugs. The first two weren't too bad, but for some reason the last one was pretty uncomfortable, but I knew I wasn't going to die, and WTH, 20 minutes? Except the doc couldn't find the polyp he'd snipped, and spent an extra 30 minutes going back and forth from top to bottom. Ugh....but nobody died and I didn't ruin a day recovering from the meds.
Not sure what I'll do next time.

 

[Sunset]

my last three I did without any drugs. The first two weren't too bad, but for some reason the last one was pretty uncomfortable, but I knew I wasn't going to die, and WTH, 20 minutes? Except the doc couldn't find the polyp he'd snipped, and spent an extra 30 minutes going back and forth from top to bottom. Ugh....but nobody died and I didn't ruin a day recovering from the meds.
Not sure what I'll do next time.

Oh My.....
I was in another country about 25 yrs old when I saw the toilet bowel was red. !!
Within a day or two (I forget) I was in a hospital getting a colonoscopy. There it was done without drugs...
It was not fun, uncomfortable to say the least.
Nothing bad was found.

I really do appreciate getting them done here in US, where I'm knocked out.

 

[bobandsherry]

I am confused by your post. I have an ACA policy in NY State. I had my regularly scheduled colonoscopy (Rx'd every 5 years; no hx of cancer but positive for benign polyps), they found a new polyp which they excised.
I never got a bill for anything.

Same here....

 

[davebarnes]

Well, after reading post#1, I then read this - https://clearhealthcosts.com/blog/2016/02/free-colonoscopies-theyre-free/

Makes me very happy with Kaiser.

 

[jonat]

I'm a little confused too (no smart remarks, please!).

I've had three colonoscopies, and the first and third both found and removed benign polyps. Haven't had to pay for anything yet. My supplemental picked up the difference, but Medicare paid the bulk of the bills.

Same here, but private insurance, not Medicare. The bills came to over $10K, but I paid zero. Second one found and removed polyps.

That said, the distinction is valid and other insurance might treat it differently. And of course you will have no idea going in which will be the case.

 

[Bamaman]

While you are being proactive with your healthcare, are you having a full physical including a chest xray every year?

Lung cancer is THE biggest cancer killer, and so many people find themselves stage 4 and terminal when they find they have cancer. Had they been getting yearly physicals, they could have found the problem before it was too late.

We recently buried a 72 year old friend that had lung cancer. He was the last of our friends that smoked in recent years.

 

[bingybear]

I'm a little confused too (no smart remarks, please!).

I've had three colonoscopies, and the first and third both found and removed benign polyps. Haven't had to pay for anything yet. My supplemental picked up the difference, but Medicare paid the bulk of the bills.

medicare considers colonoscopies as diagnostic even when polups are found.

At 50 they found one pre-cancerous polup and the second test found nothing. I got to pay for both. This was under employer health care and cobra. If you have a decent network on your health insurance, shop the providers. I found large price variations.

 

[Teacher Terry]

Colonoscopy does carry the risk of perforating your colon which is often fatal. As you age the lining of your colon gets thinner. One of my friends had her last one at 70 for this reason. Not sure what I intend to do.

 

[braumeister]

Colonoscopy does carry the risk of perforating your colon which is often fatal. As you age the lining of your colon gets thinner. One of my friends had her last one at 70 for this reason. Not sure what I intend to do.

That's a legitimate concern. The guy who has done all three of mine said that he discourages anyone over 75 from having it done for this reason.

 

[fh2000]

I did my 3rd colonoscopy late last year. Surgical center changed $8,230, and I pay $0. Doctor removed 2 polyps and sent to do biopsy. I got 2 bills. I paid the doctor $120 and pathology $65. Both polyps are benign.

 

[Live And Learn]

While you are being proactive with your healthcare, are you having a full physical including a chest xray every year?

Actually yes but not an xray - I get a low dose lung cancer CT screening. It's $99 and well worth it after having smoked from age 16 - 45 and was subject to second hand smoke from conception !

 

[upset264]

This is not an area to cut corners. I was reluctant to have my first. Always told the doctor I'll do it but not right now. One day he asked if an intern could do my exam. She asked me about colonoscopy. I said yes I'm going to get one someday. She said, "well lets set that up right now". I didn't argue knowing it was the right thing to do.

They found a couple of large pre-cancerous polyps. I had to have surgey and remove four inches of my intestine. I'll always remember that doctor. She probably saved my life or at a minimum a whole lot of trouble.