Help me out here. My wife is an ex-GI nurse and my SIL has also been told this by the insurance company. If a person goes into the procedure as preventative screening and then a polyp is found and treated with a snare or whatever, the procedure is no longer covered a preventative and additional cost is passed on to the patient. Ever hear of that? Personally, it wouldn’t change my mind for a screening colonoscopy, because the whole game is early detection (and treatment)
Yes, this is a common issue with insurance coverage for screening colonoscopies. Under most health plans, a screening colonoscopy is fully covered as preventive care as long as no abnormalities are found. However, if a polyp is detected and removed, the procedure is often reclassified as diagnostic, which can result in additional out-of-pocket costs for the patient.
This policy has been widely criticized because early detection and removal of polyps is exactly what makes colonoscopies so effective in preventing colorectal cancer. Some states have passed laws requiring insurance companies to cover polyp removal as part of preventive care, and Medicare is gradually eliminating cost-sharing for these procedures, aiming for full coverage by 2030.
Since policies vary by insurance provider, it's always a good idea to check directly with the insurance company before the procedure and ask whether polyp removal will still be covered as preventive care. Despite the insurance complications, regular screening remains essential for early detection and prevention. If you have any concerns, I’d encourage you to speak with your doctor or insurance provider to get the most accurate information for your situation.
I was aghast when I found out a friend near 70 never had a colonoscopy but was scheduling one because he is on a transplant list. Even more shocking, his wife a nurse never had a mammogram.
That is definitely concerning. Screening tests like colonoscopies and mammograms save lives by detecting cancer early, when it’s most treatable. It’s surprising how many people, even those in the medical field, put off these essential screenings. Sometimes it’s fear, misinformation, or just life getting in the way—but stories like this are a reminder of why raising awareness is so important. Hopefully, your friend and his wife stay on top of their health moving forward!
Losing social connections is one aspect of health no one realizes how important it is. And this especially important as one ages. So many elderly people are isolated and their health deteriorates very quickly. We saw this during 2020/2021.
Help me out here. My wife is an ex-GI nurse and my SIL has also been told this by the insurance company. If a person goes into the procedure as preventative screening and then a polyp is found and treated with a snare or whatever, the procedure is no longer covered a preventative and additional cost is passed on to the patient. Ever hear of that? Personally, it wouldn’t change my mind for a screening colonoscopy, because the whole game is early detection (and treatment)
Yes, this is a common issue with insurance coverage for screening colonoscopies. Under most health plans, a screening colonoscopy is fully covered as preventive care as long as no abnormalities are found. However, if a polyp is detected and removed, the procedure is often reclassified as diagnostic, which can result in additional out-of-pocket costs for the patient.
This policy has been widely criticized because early detection and removal of polyps is exactly what makes colonoscopies so effective in preventing colorectal cancer. Some states have passed laws requiring insurance companies to cover polyp removal as part of preventive care, and Medicare is gradually eliminating cost-sharing for these procedures, aiming for full coverage by 2030.
Since policies vary by insurance provider, it's always a good idea to check directly with the insurance company before the procedure and ask whether polyp removal will still be covered as preventive care. Despite the insurance complications, regular screening remains essential for early detection and prevention. If you have any concerns, I’d encourage you to speak with your doctor or insurance provider to get the most accurate information for your situation.
Thanks
I was aghast when I found out a friend near 70 never had a colonoscopy but was scheduling one because he is on a transplant list. Even more shocking, his wife a nurse never had a mammogram.
That is definitely concerning. Screening tests like colonoscopies and mammograms save lives by detecting cancer early, when it’s most treatable. It’s surprising how many people, even those in the medical field, put off these essential screenings. Sometimes it’s fear, misinformation, or just life getting in the way—but stories like this are a reminder of why raising awareness is so important. Hopefully, your friend and his wife stay on top of their health moving forward!
Losing social connections is one aspect of health no one realizes how important it is. And this especially important as one ages. So many elderly people are isolated and their health deteriorates very quickly. We saw this during 2020/2021.
I couldn't agree more with you Danni. Great to have Substack so that we all can connect!