Are followup colonoscopies counted as preventative?

[Tdubz]

Hey guys,

I have my first post chemo colonoscopy this week and I was curious if it counts as preventative care. I had to pay for a portion of the colonoscopy that diagnosed my cancer and now I’m wondering if I should have had to pay anything at all for that one. Preventative care is supposed to be free on insurance and from a few quick searches on the internet, it looks like that includes colonoscopies. I’ll call my insurance when they open but I was just curious what yalls experiences are. I’ve read it can come down to what the doctor bills it as so maybe it wouldn’t hurt to check with him too.

[zephyr]

My experience was that it was not considered preventative. The explanation I was given was that if you have no reason to believe anything is wrong, it's considered preventative -- but otherwise no. Again, this was just my experience -- your insurance company may treat it differently.

Edited to add: I'm not done with chemo. My follow-up colonoscopy that was not considered preventative was the first one after the removal of a cancerous polyp (with clear margins) several years ago.

[Lee]

This was years ago when "Obamacare" was still kinda new. I was told some procedures were considered preventive as long as there was not a preexist condition. In other words mammograms are preventative as long as you have not been diagnosed with breast cancer. Yes I always pay a portion of my scopes and I get my mammograms for free.

I am not with Obamacare, butt rather have insurance through my husband's company.

Lee

[benben]

Hey guys,

I have my first post chemo colonoscopy this week and I was curious if it counts as preventative care. I had to pay for a portion of the colonoscopy that diagnosed my cancer and now I’m wondering if I should have had to pay anything at all for that one. Preventative care is supposed to be free on insurance and from a few quick searches on the internet, it looks like that includes colonoscopies. I’ll call my insurance when they open but I was just curious what yalls experiences are. I’ve read it can come down to what the doctor bills it as so maybe it wouldn’t hurt to check with him too.

Hey Tdubz - how goes it?

I know I was following closely behind you in chemo sessions and I've got my first post-treatment scope Tuesday. So gonna eat up some good foods today, as tomorrow its all liquid. Not to mention 6pm is the beginning of the "toilet" march with the "GoLytely" (haha, yeah quite the opposite of lightly.)

Anyhow as far as the colonoscopy being preventative, I can tell you this - I had what's called my surgery pre-admission meeting last week to go over everything. First thing out of the gate I was sent to a booth where they showed me my anticipated out of pocket cost for the colonoscopy. I'll be paying $2900 out of pocket, and they made sure to let me know that's just for the procedure. There will be an additional bill for the GI Doc doing the scope. This single procedure pretty much covers my entire out of pocket expense for the year though. So if I end up needing any more treatment (praying to God I don't) - it'll be covered. Right after they showed me this bill I was sent to another room to get my vitals such as blood pressure. Then they wondered why it was on the border of being high. I was like, "Well if you want a better reading, maybe you should show your patients the bill after you take blood pressure readings." LOL.

I wish squeaky clean scopes for the both of us
Cheers.

[Ron50]

I am in Australia so none of the same rules apply. But if you are asking if they are preventative only the health system would be under the illusion that they aren't. Colonoscopies are rarely for looking for recurrence. That is why we have scans. Polyps are the main target. I have had around a dozen scopes. The only one that found cancer was the first. During at least half of my scopes polyps were found and removed , not cancer , potential cancer. My last scope was in april last year , my twentieth year of survival ex stage 3c. They found four tubular adenomas , the biggest 11 mm. There is no doubt in my mind that scopes are preventative. By the way that scope did not cost me anything as I was 67 and on the age pension. Hope you have good results , Ron.

[Deb m]

I think after five years of being clear, it's considered preventive. My husbands three year follow up ,we still had to pay. Have one coming up this summer, which will be over 6 years NED. Not sure what to expect. I did call and ask my insurance company and they said it all depends on how the doctor bills it.