Any info out there about a colonoscopy budget?

[disneybound31]

Yeah, I know.

A budget for a colonoscopy??? This may be too graphic, but I really don't know where else to turn for honest information...

I am 37; for almost a year I have been having some 'elimination' issues...(is that tip-toeing enough?)-((specifically with bleeding)) so finally I went to a gastro dr. today and he immediately scheduled a full-fledged, under anesthesia colonoscopy for the end of the month.

So I go with his recommendation, but then on my drive home I begin to think about the cost involved. I have BCBS(Tennessee) and I very rarely go to any doctor: 1.) because I have been blessed with good health and 2.) because when I do my insurance burns me and I have HUGE medical bills.

MORE PERSONAL INFO HERE: I told the Dr. that since my 2nd pregnancy 10 years ago I have struggled with bowel problems EXCEPT when I keep my weight down, drink lots of water and really watch my diet...when I do those things I have very little problem with 'movements' and bleeding.

LOOOONG story short- I called the insurance and they told me that, at my early age, that proceedure would most likely NOT be covered very extensively and could cost me upwards of $3-5k...what do you guys think?

I almost wish I had not mentioned the issue at my yearly gyn appn. last month- my gyn Dr. called in the gastro appn. right away and I felt a bit forced to go....no family history, BTW.

Thanks guys-

 

[livinlife25]

If you are having problems and your gastro recommends a colonoscopy it should be covered. I have had 5 from the age of 18-27 and they were all covered by insurance. Stick with the gastro, this is what they do. As for average cost, I thought mine was more like 8-10K before insurance.

 

[Kellydelly]

It would be worth the money to find out you have a hemorrhoid issue and not a big ugly mass in your colon. I would not have gone a whole yr with bleeding issues. Please take care of yourself!

 

[dawnball]

Get the doctor/outpatient clinic to get a pre-approval for it, then you'll know you're covered. The center you schedule it at should be able to give you a "base" cost for having it done with your insurance. It's a standard procedure, with a fixed price (assuming no complications).

The one I had this year was about 8K pre-insurance. I paid about 1K once everything was said and done.

Also, if you decide to do it, ask if your GI have an approved prep with miralax and gatorade instead of the go-lytely/nu-lytely junk. It isn't covered by insurance (because it's all OTC), but I'd rather buy some gatorade and miralax than drink the prescription stuff. I purchased mixed flavors (no red) of gatorade, and the variety really helped with slugging it down.

 

[Sadie22]

Call the doctor's office and ask what the costs are and if they have had any problems getting a medically-necessary procedure covered by your insurance company. I have had this procedure twice on an emergency basis. I was over 50 the first time. They got me in sooner than a month (I think it was within a week), and since our insurance covered tests 100 percent, it was covered.

The prep stuff is not bad and was provided by the doctor's office the first time and covered by insurance through the pharmacy the other time. The prep has changed over the years. There's less of it and it's not bad if you chill it and drink it quickly. Use what is prescribed, not something else which may not work as well and will necessitate you doing everything all over again due in inadequate preparation.

 

[floridafam]

I would get the colonoscopy. If you are having issues and the Dr. recommended the test then insurance should cover it.

 

[disneybound31]

OP here: This is really good info- I really appreciate it.

I do wish I had not waited a year, but for several months I honestly thought I was just starting my monthly early...then when I finally admitted to myself that it was more than that I could not get in to see the gyno for multiple months.

I think I will call the gastro dr. in the morning and tell them my concerns and see if they can do that pre-approval/info deal...I can definately handle 1K, but my fear is that is would $3, 4 or even 5k out of pocket and we cannot handle that kind of hit. I need to put one kid in braces this year, not at all for cosmetic reasons, but for medical reasons. I am very used to putting the kids and DH needs first and ignoring my own--but if I am not here and healthy their world would implode...

Not saying that I am the center of anyones universe and all---just saying that I would be devastated for my kids to have to deal with a sick mother if I can prevent that.

My own mother would seriously admonish me if I do not have the proceedure, but still spend $2k+ to take my kids on the surprise WDW trip December 2013 that DH and I are planning and saving for...

 

[tajz90]

Have you considered a prolapse, specifically a rectocele prolapse? Difficult eliminations and such. Look it up.


Also, our family doc suggest my mom have a colonoscopy and she refused. He then suggested a fecal occult blood test. If they found blood in stool, they would proceed with colonoscopy.

Good luck

 

[disneybound31]

Have you considered a prolapse, specifically a rectocele prolapse? Difficult eliminations and such. Look it up.


Also, our family doc suggest my mom have a colonoscopy and she refused. He then suggested a fecal occult blood test. If they found blood in stool, they would proceed with colonoscopy.

Good luck

Okay- I looked it up...this very much describes what I am dealing with on a weekly basis.

I feel like there is some sort of prolapse and have for a long time. So maybe I should call the gyno and have her re-check? I am sooo not used to going to drs...we live in a small town and they are an hour round trip which is not too big a deal- I am just not used to doing this.

THANK YOU for giving me this info to look into!!

 

[knockUout]

I am an anesthetist and provide sedation for colonoscopies four days/week. Something to be aware of --many colonoscopies are being covered 100% if they are done for screening. If the gastroenterologist finds a papilloma or polyp and removes it (as he should) it then becomes a diagnostic procedure and the patient then assumes responsibility for cost including deductible.

 

[jrw118]

I am saying this as a public service announcement not to upset you op. In October of 2010 I was having some "difficulties" like yours and they had been going on for some time . I went to the GI doc who also suggested a colonoscopy. To make a long story short when I woke up from the test the doctor told me he was 95% sure I had rectal cancer. Pathology confirmed stage III rectal cancer. I was only 36! If I had not had the colonoscopy I WOULD NOT have known. I am here today because of a primary doctor who sent me to a GI doctor who wanted to know for sure what was going on. This GI doc thought it was irritable bowl syndrome and was surprised by the cancer. My advise is to have it done. After all I have been through with chemo, radiation, more chemo and 3 surgeries I have come to the understanding that it is only money. My kids were 2 & 5 at the time I my diagnosis. It took a proactive doctor to save my life and allow me to be here for my sons. Good luck op. you're in my prayers.

 

[ShelsGoingToDisney]

I want to concur with PP jrw118. My mom was diagnosed at the age of 37 in 1986 with rectal/colon cancer and had issues as have been described. She had no family history at all. She was put off by a primary care Dr who blew it off and figured it was probably hemorrhoids. Over 6 months passed before she returned again and by that time it ended up being much worse. At the time the Drs only gave her a 20% chance at a 5 year survival. Fortunately she is still with us today at the age of 63! Like the PP I'm not telling you this to scare you but to let you know it happens and it is worth your $$ for peace of mind.

Due to mom's diagnosis I am considered a higher risk and I have had 3 colonoscopies, all clear thankfully. My insurance has changed between them so cost varied. I have had one covered 100% as a preventative thing and the others I had to pay a deductible. Worst I've had to pay was $700.

Call the Dr and find out what the costs are. Since you have symptoms you probably won't qualify for the preventative type but your insurance should help you get the contracted rate and then you should only have to pay up to your deductible depending on your type of insurance. Knowing how the Dr will code the procedure will help your insurance company give you a more definitive coverage/cost amount.

 

[dawnball]

The prep stuff is not bad and was provided by the doctor's office the first time and covered by insurance through the pharmacy the other time. The prep has changed over the years. There's less of it and it's not bad if you chill it and drink it quickly. Use what is prescribed, not something else which may not work as well and will necessitate you doing everything all over again due in inadequate preparation.

I guess I didn't explain myself well - I asked my GI about the gatorade/miralax prep, which is a standard alternate preparation for the procedure. He provided me with a prep sheet, which I followed. Doctors tend to have prescribe the "standard" prep, but usually they have 4-5 possible preparations to could offer based on preference/insurance/medical situation/etc. They all work equally well if you follow the guidelines.

I certainly wouldn't suggest that someone follow vague internet instructions before a $8K procedure, and I'm sorry for sounding like that's what I meant.

 

[swilshire]

Definitely have the test. The piece of mind will be worth whatever it costs.

Both DH and I have had the procedure covered by BCBS in Tennessee. Unfortunately, there are several "brands" of Blue Cross in the state, so your experience may vary. I don't recall our cost on either one, but it must not have been a lot because I would definitely remember.

Sheila

 

[seashoreCM]

... LOOOONG story short- I called the insurance and they told me that, at my early age, that proceedure would most likely NOT be covered very extensively and could cost me upwards of $3-5k...what do you guys think?

I almost wish I had not mentioned the issue at my yearly gyn appn. last month- my gyn Dr. called in the gastro appn. right away and I felt a bit forced to go....no family history, BTW.:

You need to have the colonoscopy.

Would you play Russian Roulette to save five thousand dollars? The bolded parts above show that you are addressing the subject in the wrong manner.

Not saying you definitely have a problem now but a year from now you don't want to get a nasty surprise or rude awakening from your doctor that you may have only six months more to live because colon cancer was not caught early enough.

Double check with your health insurance company. Some companies are adding or increasing coverage for colonoscopies because they too don't want to find their major medical coverage tapped for curing the cancer.

Not getting colon cancer is not purely luck, there is skill involved. Like doing the "fecal occult test" and getting a colonoscopy.

Some comments from the information sheet from mine (very recent):
* The majority of people who get colon cancer have no family and no symptoms.
* Most often there are no signs or symptoms that someone has developed colon cancer.
* Colon cancer affects both men and women equally and all races.

Also: Hemorrhoids and polyps that are not cancer now can become cancerous. Ergo you greatly cut down on the chances of cancer by having the colonosopy every so many years where they "clean off" the polyps etc.

A lot of folks need to be scared into going ahead and getting a colonoscopy.

Stop and brainstorm and think for an hour right now. Imagine what activities in life you would need to add or change if you got cancer. Imagine what activities in life your family would need to add or change if you died from cancer. Think in terms of a play choreographer or a play by play sports announcer, outlining the steps needed for a week.

And think about what a shame it would be for the rest of yourself in excellent health to go to waste because of previously undetected colon cancer down in your crotch.

I've run out of space in this reply/column and run out of your attention span so I shouldn't point out any more graphic details but I suggest you do a Google search on "colostomy". Now are you scared?

Please report back to us in early September (after your colonoscopy) to tell us whether you should receive the "I Beat Cancer" medal for taking preventive action.

Health hints: http://www.cockam.com/health.htm

 

[Jenny3]

Go get the procedure done; trust me, it is NOT THAT BAD. The prep is pretty vile, but the procedure itself is nothing.

I had one last year - I had no issues, no bleeding, no pain, no symptoms, nothing at that something was amiss. I went due to my family history. I was fully prepared to get a clean bill of health and never think about it again. I had 5 polyps; one of which was pre-cancerous and growing. I'm 37 years old. They removed it and now I have to go every 3 years for a check. If I had put it off or waited until I was at the recommended age of 50, no doubt it would have been full blown cancer by that point.

Get it done; you can deal with the finances later. Do this for you, for your health - and for your kids.

Good luck

 

[Swan4Me]

Call the Gastro's office-have THEM check your insurance-mine knows to the penny what is covered by what insurances-stop second guessing-do it today.

I do this test every other to every 3 years , even tho my Uncerative Colitis is in remission...my Blue cross usually "discounts" what they charge and it goes on my Major medical...I doubt i have ever paid more than $1000 every time

 

[Marionnette]

Yeah, I know.

A budget for a colonoscopy??? This may be too graphic, but I really don't know where else to turn for honest information...

I am 37; for almost a year I have been having some 'elimination' issues...(is that tip-toeing enough?)-((specifically with bleeding)) so finally I went to a gastro dr. today and he immediately scheduled a full-fledged, under anesthesia colonoscopy for the end of the month.

So I go with his recommendation, but then on my drive home I begin to think about the cost involved. I have BCBS(Tennessee) and I very rarely go to any doctor: 1.) because I have been blessed with good health and 2.) because when I do my insurance burns me and I have HUGE medical bills.

MORE PERSONAL INFO HERE: I told the Dr. that since my 2nd pregnancy 10 years ago I have struggled with bowel problems EXCEPT when I keep my weight down, drink lots of water and really watch my diet...when I do those things I have very little problem with 'movements' and bleeding.

LOOOONG story short- I called the insurance and they told me that, at my early age, that proceedure would most likely NOT be covered very extensively and could cost me upwards of $3-5k...what do you guys think?

I almost wish I had not mentioned the issue at my yearly gyn appn. last month- my gyn Dr. called in the gastro appn. right away and I felt a bit forced to go....no family history, BTW.

Thanks guys-

My mother just had a malignant mass removed from her colon in May. They're confident that they got it all. Waiting for the biopsy result was hell on earth.

Get the damn test done and stop thinking about the cost!!! Money means nothing if you're unable to enjoy it. cancel a vacation. Put off buying a new car. Do whatever it takes if your insurance denies coverage. But do not leave this unaddressed because of the price tag. You have two kids who need their mom. Hell, I'm 52 and I still need my mom.

 

[tinker&belle]

Get it done, no matter the cost. My MIL died of colon-rectal cancer at the old age of 46, she was waiting to get insurance coverage to get her colonoscopy. While she waited it became Stage 4 cancer. Do it. Today if you can.

 

[disney1990]

Please do not put it off. If you have to pay some of the cost, it is worth it for the peace of mind. But, you doctor should be able to get it paid for you because of the problems you have been having.