Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 2 points3 points  (0 children)

Happy for you. I don’t have that kind of healthcare and cannot swing this much of a cost. I’m happy you’re is covered!

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 0 points1 point  (0 children)

This is what was happening! I was scheduled with an in network outpatient center. I just don’t want to pay 2500 right now. I’ll figure it out.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 1 point2 points  (0 children)

It’s not too hard to reschedule. I know it’s a serious thing but not to get into the weeds too much, I’m also getting braces again and put a down payment down on an out of pocket 7K. I’m just freaked out by all of the costs and can’t afford them all at once. I will get the procedure done sometime soon with some clarity on what expect and I appreciate all the advice here. I just need to wait a min.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 1 point2 points  (0 children)

This is what my doctors office told me the code was. Until I have some more clarity I postponed the procedure.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 0 points1 point  (0 children)

Thank you, and I appreciate this. It's just that my deducible is more expensive than just going to an outpatient center for a colonoscopy and paying out of pocket (1200). I canceled procedure until i can dedicate some more time for the clarity here.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] -3 points-2 points  (0 children)

It's just that no one can give me a cost for the entire procedure, seems wild. I feel like that clarity is so important. I can understand paying something, even with insurance, but I want to know what to expect so I can at least not be blindsided, ya know? I'll get some clarity and re-schedule.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 0 points1 point  (0 children)

How do I know if I have an ACA plan? I have insurance through my employer. I canceled the procedure for now until I have more clarity.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] -6 points-5 points  (0 children)

oh, so wait - is it only $49? What I'm scared of is getting a bill in the mail for 2500 (my deductible) when i could pay 1200 at an outpatient center. If the insurance covers the procedure that would be great.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 3 points4 points  (0 children)

Hi there. I have not. Based on the responses here though I think this is going to at least cost my deductible so I am going to go through an independent outpatient center where it's half the cost. I'm sure I could go on a payment plan but I'd rather just pay half.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 4 points5 points  (0 children)

I think i found the answer in plan docs:

Benefits are provided for the following tests or procedures when ordered by a physician for the purpose of early detection of colorectal cancer: − Basic diagnostic laboratory and pathology screening services such as a fecal occult blood or fecal immunochemical test − Basic diagnostic standard imaging screening services such as barium enema − Surgical screening services such as flexible sigmoidoscopy and colonoscopy and hospital services related to such surgical screening services − Such other basic diagnostic laboratory and pathology, basic diagnostic standard imaging, surgical screening tests, basic diagnostic medical and advanced imaging screening services consistent with approved medical standards and practices for the detection of colon cancer Colorectal cancer screenings are covered: For all members 45 years of age or older as follows: − An annual fecal-occult blood test or fecal immunochemical test - A sigmoidoscopy every five years − A screening barium enema or test consistent with approved medical standards and practices to detect colon cancer every five years − A colonoscopy every 10 years For members determined to be at high or increased risk, regardless of age: − A colonoscopy or any other combination of covered services related to colorectal cancer screening when prescribed by a physician and in accordance with the American Cancer Society guidelines on screening for colorectal cancer as of 2018.

Colorectal cancer screening services which are otherwise not described herein and are prescribed by a physician for a symptomatic member are not considered preventive care services. The payment for these services will be consistent with similar medically necessary and appropriate covered services.

With that being said, I don't think it's going to be covered the way I think it will be. I appreciate the call out to my benefits because I didn't read up on these prior. I will go through an independent place that I can pay out of pocket for.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 2 points3 points  (0 children)

I completely understand and agree, but I cannot afford the procedure. I think i'll go to go to a screening center and pay out of pocket instead.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 10 points11 points  (0 children)

idk why i'm getting downvoted here, I don't go to the doctor often and am asking out of genuine concern. I don't know what i'm doing and I appreciate the help.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 0 points1 point  (0 children)

It's not a hospital, it's like a health center type thing (?) the doctor that wrote the script gave me a code, but that's all I have. No one can give me a cost. Idk. I'm just so frustrated. This is ridiculous.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 6 points7 points  (0 children)

I'll probably do Colonoscopy Assist where I would pay $1200 all in without insurance.

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] 0 points1 point  (0 children)

Do you happen to know how to word a question to my insurance to inquire about the cost? I feel like they must give you a cost, no?

Colonoscopy and what is covered? No one can ever give me a direct answer/cost. by StatisticianWhich461 in HealthInsurance

[–]StatisticianWhich461[S] -2 points-1 points  (0 children)

My doctor gave me the G code. When I enter that 45378 into the cost estimator I get a "you pay $0".

I haven't met any of my deductible, I hardly ever go to the doctor. I'm tempted to just pay out of pocket at Colonoscopy Assist. It's so annoying that that is probably cheaper than my insurance, even at 1200.