Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. I did have a few small polyps at my last one 5 years ago. So that has now changed them forever to diagnostic? That seems crazy. Insurance is such a racket.

When did your gastroenterologist tell you to come back next time?

The ACA makes preventative tests free for the patient, but yours was no longer considered preventative since you previously had polyps removed.

5 years

You'll need to pay again next time.

DP, but maybe not. That will be at the ten year mark. OP, I'd ask my provider to class/code that one as screening. It's not like it's a different procedure.

But 5 years from the previous colonoscopy. If the gastroenterologist told her she could come back in 10 years, then the next one could have been screening. But based on the size or pathology of the first polyp, she's apparently still considered high risk.

PP here - you're right. I don't do math very well.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:God, healthcare in this country SUCKS.

No. It really doesn't.

Spoken like someone who has always had Cadillac insurance provided by their employer.

Yup. I have actually lived abroad in one of those horrible socialist countries (think Nordic) and even paying full price completely out of pocket, the healthcare we received was better, faster, and CHEAPER.

So I’ll repeat: healthcare in this country SUCKS.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. I did have a few small polyps at my last one 5 years ago. So that has now changed them forever to diagnostic? That seems crazy. Insurance is such a racket.

When did your gastroenterologist tell you to come back next time?

The ACA makes preventative tests free for the patient, but yours was no longer considered preventative since you previously had polyps removed.

5 years

You'll need to pay again next time.

DP, but maybe not. That will be at the ten year mark. OP, I'd ask my provider to class/code that one as screening. It's not like it's a different procedure.

But 5 years from the previous colonoscopy. If the gastroenterologist told her she could come back in 10 years, then the next one could have been screening. But based on the size or pathology of the first polyp, she's apparently still considered high risk.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. I did have a few small polyps at my last one 5 years ago. So that has now changed them forever to diagnostic? That seems crazy. Insurance is such a racket.

When did your gastroenterologist tell you to come back next time?

The ACA makes preventative tests free for the patient, but yours was no longer considered preventative since you previously had polyps removed.

5 years

You'll need to pay again next time.

DP, but maybe not. That will be at the ten year mark. OP, I'd ask my provider to class/code that one as screening. It's not like it's a different procedure.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Is this a high deductible plan? Even if it's a diagnostic a 1500 copay is insane. Even surgery has only a 100 to 150 copay on BCBS.

I do have a high deductible. The plan is BCBS CareFirst via DC Healthlink. It’s like a sucker punch every time I need anything—no one can give an estimate, so it’s just wait and see. That said, I just didn’t expect it with a colonoscopy.

Next time, tell them you have no insurance first and see what the quote is. Often it's less to just pay out of pocket than have crappy insurance.

But then you'll still have to pay your deductible if you need anything else that year.

Unless you're in your 20s, you should just plan to have to pay out your deductible every year.

I had CareFirst from the exchange in MD.

1. Deductibles are high
2. Hospital fees are not usually covered (almost never)
3. The actual colonoscopy may be covered at 100%, but remember there are separate bills for the anesthesiologist, pathology, etc.
4 Yes, it is a high bill. Even if you have a “great” comprehensive plan it is really not all that.

Double check your bill. Ask for an itemized bill. Call the hospital and negotiate.

I am sorry. Healthcare is very frustrating. Good luck.

Anonymous wrote:

Anonymous wrote:Is this a high deductible plan? Even if it's a diagnostic a 1500 copay is insane. Even surgery has only a 100 to 150 copay on BCBS.

I do have a high deductible. The plan is BCBS CareFirst via DC Healthlink. It’s like a sucker punch every time I need anything—no one can give an estimate, so it’s just wait and see. That said, I just didn’t expect it with a colonoscopy.

Next time, tell them you have no insurance first and see what the quote is. Often it's less to just pay out of pocket than have crappy insurance.

I’ve had colon cancer, so get colonoscopies every 3 years. I’ve noticed the cost to me is about half if I choose the doc’s private practice location rather than the hospital.

Anonymous wrote:

Anonymous wrote:Is this a high deductible plan? Even if it's a diagnostic a 1500 copay is insane. Even surgery has only a 100 to 150 copay on BCBS.

I do have a high deductible. The plan is BCBS CareFirst via DC Healthlink. It’s like a sucker punch every time I need anything—no one can give an estimate, so it’s just wait and see. That said, I just didn’t expect it with a colonoscopy.

If you weren’t at risk for colon cancer, it would be covered (as diagnostic). Good for you for taking care of your health.

Anonymous wrote:Is this a high deductible plan? Even if it's a diagnostic a 1500 copay is insane. Even surgery has only a 100 to 150 copay on BCBS.

I do have a high deductible. The plan is BCBS CareFirst via DC Healthlink. It’s like a sucker punch every time I need anything—no one can give an estimate, so it’s just wait and see. That said, I just didn’t expect it with a colonoscopy.