Any info out there about a colonoscopy budget?

[ilovemk76]

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-

When I had my colonoscopy, the total bill was over $6K. With my deductible and split, my cost was $2K.

Colon cancer runs in my family. A few family members have died from it. My test was polyp free.

DH had his, no colon cancer in his family, and they removed a few polyps.

 

[jrw118]

I am sorry to say that I have no idea why money would prevent anyone from getting a test that could save your life. Certainly I would hope that life is priceless. I do understand that some people are better off than others monetarily BUT this is a Disney board and frankly there should be no comparison between a colonoscopy and a trip to Disney if there are medical concerns.
I have spent the last 2 years treating cancer and the medical charges were well over $2 million dollars (most covered byninsurance)I have spent nearly 30 days in the hospital. To me I would spend everything I had just for one more day with my boys. In my case this test saved my life. I just had my 2 nd colonoscopy last week and it was all clear ( thank god). I will have them every year for the rest of my life and I don't care if it is covered.

 

[Hrhpd]

Get it done ASAP!

Most docs will let you set up a payment plan if you need it.

Just do it!

 

[dennise]

Here is Canada, even if you had to pay for it, it would be less than 1K. Pico Salax is the bowel prep most often used, it is OTC and is less than $20. Don't put a price on your life, it is worth more than the K's it would cost. To your family and for your peace of mind you're worth it. Disney will always be there.

 

[tajz90]

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!!

You can have a prolapse and a doc will not mention it. A lot of women have them and live with them with no issues. I would specifically ask your Gyno or broach the subject with the doc that suggested a colonoscopy and see if he thinks that could be the issue. If you can avoid the test because it is another diagnoses, do. Of course, if you have to have one price shouldn't be an issue. You can work out payment with the hospital and tell them it's not something you can afford. They may lower your price.

 

[LJSquishy]

My husband had a colonoscopy done last year at age 31 as he was having bowel/digestive problems. Our out of pocket expenses, after insurance, ran about $750. We actually weren't expecting to have to pay even that much so we had to schedule a payment plan with the hospital electing to pay $50/mo until it was paid off...we of course paid it off much faster, but made sure our required payment was low in case something came up.

They removed one tiny polyp but didn't ever find anything causing his problems so he still has issues.

Unless you have a strange insurance coverage plan, you shouldn't have to pay more than $1,000 out of pocket. Make sure your doctor recommends a colonoscopy so that insurance covers it.

 

[floridafam]

My brother had a colonoscopy after years of being told his problems were just hemmorrhoids. He had colon cancer and it had already metastasized to his liver.

Get the test done. Work out a payment plan.

 

[disfan07]

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-

It should be covered. Have your doctor submit a pre approval and see what happens. I am only 23 and I've been having GI issues for a while now and our insurance covered an endoscopy last fall, a colonoscopy this past May. In fact....they approved a capsule endoscopy (expensive and rarely done) which I am having done this friday. It should be deemed medically necessary in your case. If not, fight it. Insurance companies have entire departments dedicated to refusing procedures and care that are in fact medically necessary. We've actually had to threaten to sue once before because they kept denying coverage....magically, it was suddenly deemed medically necessary

Insurance companies don't really care about the consumer....only you and your doctor knows whats best. Fight until its covered...dont take no for an answer in this situation

So my advice....try to get the doctor to get it pre approved. If not, have the procedure (you need it!) and fight your insurance company until they say yes and cover it!

 

[yoopermom]

Ditto what everyone else has said .

My only other suggestion would be to ask if your doctor has privileges at more than one hospital, and then call each of them to check on their part of the cost for the procedure. We have two hospital 20 miles apart, and the cost difference between the two is astronomical (plus the larger one uses a collections agency if you want to make payments), so we try to use doctors who have privileges at both.

Add me to the list: my DGM had terrible, terrible colon cancer, and I wouldn't wish it on my worst enemy. All of her grandkids have regularly scheduled colonscopies after watching what she went through (I'm still paying on mine from last winter, and don't begrudge a cent of it...).

Terri

 

[ceecee]

I have had several of them and the prep they have now is SO much better than the one I had years ago!
My procedure wasn't that expensive, thankfully we have wonderful insurance so that wasn't a concern. Call the Dr's office and have them call your insurance. I can't believe they wouldn't cover it since it was recommended by your Dr. Maybe they don't cover them just for screenings because of your age?

 

[ceecee]

It should be covered. Have your doctor submit a pre approval and see what happens. I am only 23 and I've been having GI issues for a while now and our insurance covered an endoscopy last fall, a colonoscopy this past May. In fact....they approved a capsule endoscopy (expensive and rarely done) which I am having done this friday.

I had that too! Strange as it sounded!!!

 

[cjnix29]

And your age shouldn't matter for that test. If there is a reason for it it should be at least partially covered. I have had one at least every two years since I was 21, now 37.

 

[MomToOne]

If the test is medically indicated, how much the insurance will pay should not matter based on your age. If they try and deny coverage of it, appeal, appeal, appeal!

 

[Green Tea]

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-

The idea that you wish you hadn't mentioned this at your checkup is just foreign to me. I can not understand how you would not want to get rectal bleeding investigated.

A friend of mine, just about your age....38, was dx with stage 4 colorectal cancer. Young, fit, healthy, non smoker, thin. She too had some issues that she passed off until the first day she found blood. GP sent to surgeon for colonoscopy immediately....yep. No family history.

I just can not imagine living with bleeding for a year and doing nothing about it and worrying about the cost. Your insurance will cover this, but regardless, you have got to follow through immediately.

 

[disneybound31]

The idea that you wish you hadn't mentioned this at your checkup is just foreign to me. I can not understand how you would not want to get rectal bleeding investigated.

A friend of mine, just about your age....38, was dx with stage 4 colorectal cancer. Young, fit, healthy, non smoker, thin. She too had some issues that she passed off until the first day she found blood. GP sent to surgeon for colonoscopy immediately....yep. No family history.

I just can not imagine living with bleeding for a year and doing nothing about it and worrying about the cost. Your insurance will cover this, but regardless, you have got to follow through immediately.

OP here:
No- I DID mention it at my checkup- it just took a month to get into the gastro guy.

I am just not sure why my gyno did not do a fecal occult test and neither did the gastro...I am going to have the colonoscopy- I just want to be educated about the cost and will be calling gastro in the morning to ask if they will get pre-approval and OOP cost info from the insurance as others have suggested.

Also, my gyn is aware that I do not have these symptoms most of the time when I am drinking plenty of water, eating well and exercising...so we had agreed for quite some time that the issue may be due to constipation and/or straining and pregnancy weight gain (very graphic, I know- I am sorry).

 

[tajz90]

Good luck and best wishes

 

[disneybound31]

If the test is medically indicated, how much the insurance will pay should not matter based on your age. If they try and deny coverage of it, appeal, appeal, appeal!

Great point- I will keep in mind.

 

[crashbb]

OP here:
No- I DID mention it at my checkup- it just took a month to get into the gastro guy.

I am just not sure why my gyno did not do a fecal occult test and neither did the gastro...I am going to have the colonoscopy- I just want to be educated about the cost and will be calling gastro in the morning to ask if they will get pre-approval and OOP cost info from the insurance as others have suggested.

They didn't do an FOBT because they (and you) know that there is fecal blood. The OCCULT means that they are searching for blood that they don't know about and that you cannot see. It is used as a screening tool - not a test you run after your patient tells you that they have fecal blood. Doing an FOBT test at this point would be pointless and a waste of money, all it does it tell you that there is blood there (which, in your case, isn't a question), it doesn't tell you anything about the reason for the blood.

And the comment about mentioning it - the PP wasn't saying that you didn't mention it. She was shocked that you regretted mentioning it.

 

[disneybound31]

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

Thank you for this- your story is what I needed to hear, thank you again...I will call for more info and have it done. I think I wigged out last night and made many excuses as to why the proceedure made no sense for me to have...I admit I am nervous and the money part scares me, but that is the fear talking and I am going to get over it.

 

[disneybound31]

They didn't do an FOBT because they (and you) know that there is fecal blood. The OCCULT means that they are searching for blood that they don't know about and that you cannot see. It is used as a screening tool - not a test you run after your patient tells you that they have fecal blood. Doing an FOBT test at this point would be pointless and a waste of money, all it does it tell you that there is blood there (which, in your case, isn't a question), it doesn't tell you anything about the reason for the blood.

And the comment about mentioning it - the PP wasn't saying that you didn't mention it. She was shocked that you regretted mentioning it.

Oh- good to know- I thought it was also a diagnostic tool to find out what type of blood and from where it might be originating...

I did see that I mis-read the PP post and made apology. Yes, I think I was just fearful and did regret it at that moment, but I now realize it is a necessary thing to do.

My DH is out of town for work this week and I am trying to juggle getting kids ready for school and taking kids to work with me each day and not being able to process it fully with him- I did not want to talk it out on the phone within earshot of the kids- made me freak out last night...