Colonoscopy

[leeniewdw]

As far as I understand it, it will not be covered at 100% if under 10 years. I was due last year for a 7 year call back and had asked the insurance company about this and was told I’d have to pay. I didn’t get into specifics as I decided to put it off until this year when I went on to Medicare. Due to covid, it may not have happened anyway last year.

I think I'm going to call today. I suspect you are correct. It's dumb because it's STILL preventative (and clearly way less expensive than any serious outcome from NOT having one).

Are you sure you actually owe these amounts they are billing you for? Ive received two bills in (I believe) error in the last week. We hit our deductible in March. Both bills were for after that for things that should be covered. Of course the insurance company cant understand or explain why I received a bill but they need to research further.

The amount were so small, I didn't really care (I know that's dumb on my part). Once I hit our deductible, things are covered 90% until we hit our max out of pocket (which we haven't).

I think it depends on your insurance company and your policy (high deductible/co-pay/etc.?).

We do have a high deductible plan, but anything preventative (like your annual physicals, mammos, etc) should be covered 100%.

I also need to look up when my DH had his. If it was late in the year, I don't think it's a big deal to push it into 2023. I believe if it's not covered it'll be $4-5k. My deductible is 4k.

 

[JediBonas]

thanks to you all for sharing on such an important and personal story!

For those who have family history that impact when your children should get their first....does insurance cover that as preventive? I ask because my kids are suggested to have their first at age 40. My first colonoscopy was at 52 and I just had my 5 yr return a few months ago (this time the report gives me a 7 yr return). Anyway, some acquaintance who are a little older were saying their kids got pushback from their insurance companies. Since these are not cheap, I wondered if anyone had experience with pre-50 screenings? It's going to be hard to convince my kids to do this at 40 but having it covered might help!

I wasn't even sure if my 5 year return was covered but we hit our high deductible before it so the out of pocket was tiny (but I should call and ask how it was covered).

I can only speak from my experience but no, usually they will not. I had my first colonoscopy in my early 20s and polyps were found. Since they were the kind that could turn cancerous I've needed several colonoscopies since then as I'm considered high-risk. Not one has my insurance covered (and I've had several different plans). My last one was last year at the age of 41 and even though my insurance's own website says those at high-risk should begin screenings at 40 they STILL wouldn't cover it. Luckily last year I was told I didn't need another until 50, so hopefully next time I won't be out $1k for a preventative test.

 

[leeniewdw]

I just reviewed my EOBs, and they were definitely not coded as preventative. The discounted cost was still nearly $3000 if I'd not met my deductible.

I would presume your post 50 would be covered, but who knows.

 

[Owlpost23]

I just reviewed my EOBs, and they were definitely not coded as preventative. The discounted cost was still nearly $3000 if I'd not met my deductible.

I would presume your post 50 would be covered, but who knows.

Get on them about that-I had a problem with a bone scan-it was a preventative test,but they coded as diagnostic.Took me forever to get that straightened out.

 

[elgerber]

Ive had three during covid. While its true your ride might not be able to stay in the building, mine has been required to stay on property. We were super fortunate with the weather thankfully.

I had one exactly one year ago. My dh didn't need to stay. They specifically told me when to tell him to come back for me.

 

[monkeydawn]

I had one exactly one year ago. My dh didn't need to stay. They specifically told me when to tell him to come back for me.

I'm shocked. At 4 different facilities/ states over a 20 year span, weve been consistently told that the driver must remain on site. Like I said I know of someone that had theirs cancelled because their driver ran an errand and couldnt be reached via cell. If someones driver isnt planning on staying you should first make sure this is allowed at your facility, I'd bet it isnt at most based on my experiences. Id hate to see anyone do the prep for naught.

 

[maxaroni]

I'm shocked. At 4 different facilities/ states over a 20 year span, weve been consistently told that the driver must remain on site. Like I said I know of someone that had theirs cancelled because their driver ran an errand and couldnt be reached via cell. If someones driver isnt planning on staying you should first make sure this is allowed at your facility, I'd bet it isnt at most based on my experiences. Id hate to see anyone do the prep for naught.

Driver is not required to stay at any of the facility that we have used. We’ve been to a number of them as I have had them since my mid 30s and a couple of moves, as well as changing doctors. One of my first times, my DH dropped me off and went to work as his office was right down the road. Each facility has required a phone number for the driver and the driver is to be available at all times. I dropped off my DH and went to work myself as I had other people out in my department. It has never been an issue for us, or when my parents had theirs.

 

[monkeydawn]

Driver is not required to stay at any of the facility that we have used. We’ve been to a number of them as I have had them since my mid 30s and a couple of moves, as well as changing doctors. One of my first times, my DH dropped me off and went to work as his office was right down the road. Each facility has required a phone number for the driver and the driver is to be available at all times. I dropped off my DH and went to work myself as I had other people out in my department. It has never been an issue for us, or when my parents had theirs.

Still shocked and I'd still encourage everyone to verify this each time so as to not waste a prep experience. I scheduled my next colonoscopy yesterday and verified about the driver having to be on site in case I was mis understanding. They reiterated that if the driver leaves, they will not perform the procedure until the driver has returned and then, it will be if the schedule allows for the colonoscopy to be completed. I've been having them regularly since my early 20s, in a few different states, and I believe I have always been told the same (driver, on site for the duration of the procedure) so obviously places handle this differently. The only message here is dont assume you can leave if you are the driver.

 

[dclpluto]

Still shocked and I'd still encourage everyone to verify this each time so as to not waste a prep experience. I scheduled my next colonoscopy yesterday and verified about the driver having to be on site in case I was mis understanding. They reiterated that if the driver leaves, they will not perform the procedure until the driver has returned and then, it will be if the schedule allows for the colonoscopy to be completed. I've been having them regularly since my early 20s, in a few different states, and I believe I have always been told the same (driver, on site for the duration of the procedure) so obviously places handle this differently. The only message here is dont assume you can leave if you are the driver.

how will they know if the driver left?
What happens if someone can’t get a driver?

 

[Allison]

I'm shocked. At 4 different facilities/ states over a 20 year span, weve been consistently told that the driver must remain on site. Like I said I know of someone that had theirs cancelled because their driver ran an errand and couldnt be reached via cell. If someones driver isnt planning on staying you should first make sure this is allowed at your facility, I'd bet it isnt at most based on my experiences. Id hate to see anyone do the prep for naught.

Wow. I have never heard of that and it has never been required for any procedures I have had or anyone that I have taken for procedures.

 

[leeniewdw]

It's required by my facility and very clearly stated over and over. Due to Covid, my DH had the option to wait in his car, so I suppose they wouldn't have known if he ran an errand, but obviously that didn't happen.

When he had knee surgery (also day) they never made such a big deal about it, but a) it's a longer surgery and time in recovery and b) he was already at a full service hospital. I wonder if it's to make sure they can keep to their schedule and get a bed opened at the facility. I was in and out in about 2 hours or so for my last one. It wouldn't take long to get backed up if no one was there to retrieve patients.

 

[sam_gordon]

DW & I both had colonoscopies done within the last year or two. We were allowed to leave the site. At least for us, our driver was allowed to wait with us in the room before being taken back for the procedure. I can't imagine dropping someone off at the facility, not being able to wait with them, AND being told you can't leave the site.

 

[lifesavacation]

It's required by my facility and very clearly stated over and over. Due to Covid, my DH had the option to wait in his car, so I suppose they wouldn't have known if he ran an errand, but obviously that didn't happen.

When he had knee surgery (also day) they never made such a big deal about it, but a) it's a longer surgery and time in recovery and b) he was already at a full service hospital. I wonder if it's to make sure they can keep to their schedule and get a bed opened at the facility. I was in and out in about 2 hours or so for my last one. It wouldn't take long to get backed up if no one was there to retrieve patients.

For mine, it wouldn’t have backed up the schedule if the driver wasn’t back when you were brought out. They just have you wait in the waiting area and when your driver gets there, the receptionist gives them the form to sign you out. That happened to someone when I first checked in.

 

[leeniewdw]

Interesting to hear the differences. They wheeled me out to my car in a wheelchair both times I've had it and my DH was called back to recovery to help (if needed) to get me dressed, gather my things, but also to hear what the Dr said. I know with his colonoscopy, he'd already forgotten how many polyps the Dr found when we got to the car and he asked me again.

Maybe my Drs facility just likes to get people moving and out of there, lol.

 

[DisneyJamieCA]

Still shocked and I'd still encourage everyone to verify this each time so as to not waste a prep experience. I scheduled my next colonoscopy yesterday and verified about the driver having to be on site in case I was mis understanding. They reiterated that if the driver leaves, they will not perform the procedure until the driver has returned and then, it will be if the schedule allows for the colonoscopy to be completed. I've been having them regularly since my early 20s, in a few different states, and I believe I have always been told the same (driver, on site for the duration of the procedure) so obviously places handle this differently. The only message here is dont assume you can leave if you are the driver.

It’s interesting to read everybody’s different experiences. At my doctor’s they don’t require the driver to stay onsite and will call them when it’s done. But they do require somebody you personally know to come get you - they won’t let you take an Uber/taxi.

 

[starry_solo]

I've had a few before I was 40, all pre-COVID. The doctor was questioning bloodwork after I mentioned that I had fainted 3 times after donating blood, even though I had never done that before [fainted that is, in the 20+ other times I donated blood]). Every time, my driver was required to remain in the area, preferably in the area where I checked in.

The medical personnel had to see the driver was there before they would allow me to check in and before I could drop my paperwork off in the appropriate spot. Then, they checked the driver was there before I was allowed inside the prep room. The facility took my driver's cell phone number but said they would first call the landline that was in the waiting area to check for the driver.

My driver was then let into the post-op room all times and given instructions, walked with me while I was wheeled out by the medical staff to the hallway and then took over, wheeling me out of the hospital. I never asked if my driver wandered away....

 

[AprilsZoo]

Please know I am laughing at the nurses talking food while you're hungry. It would be just my luck to have that happen too. lol I can just picture it and it could be in a sitcom!

Happy that you're good for 10 years!

It *was* in a sitcom… close enough anyway.
Seinfeld S3 E15– The Suicide.
Elaine must fast for days prior to a “test” she is taking at the hospital. Sitting in the wait area, she is starving and begins hallucinating from the hunger. After a long delay, she eventually ends up grabbing a Drake’s Coffee Cake right out of Newman’s hands and eating it ravenously. Thus all the fasting & prep were wasted, and she has to do it all over again when the test was rescheduled.
Not my favorite episode, but it definitely has its moments.

 

[SharonZ]

I just took my brother for his first colonoscopy last week. They asked if I would be staying, or I could leave and they would text me when he was in preop, procedure room, etc., and call when he would be ready for pickup. They did the same thing last year when he had his gallbladder removed, both times his surgeon called me on my cell phone after the procedure.

 

[lucas]

Is a COVID test required before the colonoscopy?

 

[monkeydawn]

Is a COVID test required before the colonoscopy?

Not at my facility.