How to Order Colonoscopy paid by Medicare

[Sunset]

I'm new to Medicare.

When I was on regular lousy health insurance, my doc would say I need a colonoscopy and he would make an order at the in network place.

My doctor is gone, haven't seen him in 3 years.

Now, I'm due for a colonoscopy, since on Medicare can I phone up a colonoscopy location and order one and Medicare will pay for it ?

How do I know Medicare will pay for it ?

Sort of related, how do I know what Medicare does pay for, can I ask them ?

 

[athena53]

Do you know the practice that did the actual colonoscopy? You could call them. It's in their best interest to find out beforehand if it's covered but it should be if it's past the recall date they specified last time. I've had two on Medicare and didn't pay a cent other than for the non-prescription prep stuff, which was pretty cheap.

If you have Medicare Advantage rather than traditional Medicare you may have network constraints.

 

[PaunchyPirate]

I guess larger cities have "colonoscopy locations". Here where I live, I would need to make an appointment with a Gastroenterologist's office. They would then schedule the colonoscopy at the local hospital if they agreed that was what needed to be done.

 

[Sunset]

Do you know the practice that did the actual colonoscopy? You could call them. It's in their best interest to find out beforehand if it's covered but it should be if it's past the recall date they specified last time. I've had two on Medicare and didn't pay a cent other than for the non-prescription prep stuff, which was pretty cheap.

If you have Medicare Advantage rather than traditional Medicare you may have network constraints.

Thanks... just getting anxious

I did get a letter from them saying it was time and to call to arrange for the same doctor to perform it as it was past recall time.

I did that, so I guess that counts as doc ordered.

 

[audreyh1]

DH routine colonoscopy was paid on Medicare. The doctor (gastroenterologist) he had before Medicare did it, they had called with the reminder. Took care of everything Medicare wise.

 

[audreyh1]

Thanks... just getting anxious

I did get a letter from them saying it was time and to call to arrange for the same doctor to perform it as it was past recall time.

I did that, so I guess that counts as doc ordered.

Yes.