stargazer08
Recycles dryer sheets
- Joined
- Mar 5, 2006
- Messages
- 194
Today the administrator of my health insurance plan told me that should polyps or diverticulitis or any other abnormality be found during "free" colonoscopy preventative screening that I would be responsible for the entire cost of the "free" screening.
I thought this was going against the ACA. From what I can tell there should be no cost sharing for this screening in 2013 but maybe I'm wrong.
Then it makes me wonder if any other preventative screening that turns up problems (mammogram, cholesterol screening etc) would no longer be free if they ended up finding a problem.
Am I nuts or is what I have been told true?
FAQs About Affordable Care Act Implementation Part XII
Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy?
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.
I thought this was going against the ACA. From what I can tell there should be no cost sharing for this screening in 2013 but maybe I'm wrong.
Then it makes me wonder if any other preventative screening that turns up problems (mammogram, cholesterol screening etc) would no longer be free if they ended up finding a problem.
Am I nuts or is what I have been told true?
FAQs About Affordable Care Act Implementation Part XII
Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy?
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.