insurance and colonoscopy

[Dznypal]

My new PCP insists on me having a colonoscopy

I explained to her what happened the last time which was in 2023. Im supposed to go every 5 years
and why Im so scared to go anymore--I stopped breathing twice the dr gave me to much fentanyl
since I was a fidgety..He kept giving me more since the dose wasnt working..But then it all hit my system
at once..They had to give me Narcan to reverse the overdose.

She said I could have anesthesiologist with me which could maybe help me.
Not sure thoght if my insurance will cover that.

I know all insurances are different Im on medicare.
But jsut wondering if anyone else had an anesthesiologist and insurance covered it.
I know theres people out there that dont have any sedation at all.
I have already messaged my insurance about it.

 

[Kooks and Bay Bay]

I'd call and ask Medicare what their policy is.

There SHOULD be an anesthesiologist or at least nurse anesthetist taking care of sedating you so not sure if you actually mean that non trained people were giving you sedation???

Perhaps you'd better off having general anesthesia with a breathing tube?

Do you have any conditions or a family history that's making them want to do a colonoscopy already? Its only been 2 years and if you're supposed to go every 5 then there's no reason to unless there's an issue.
Plus insurance may not pay for it if its not justified.

Or are you a good candidate for other types of tests like the cologaurd?

 

[mrsstats79]

I have medicare. Just had this done 2 weeks ago. It was covered by insurance with an anesthesiologist giving the sedative, which is just a twilight sleep.

 

[barkley]

My new PCP insists on me having a colonoscopy

I explained to her what happened the last time which was in 2023. Im supposed to go every 5 years
and why Im so scared to go anymore--I stopped breathing twice the dr gave me to much fentanyl
since I was a fidgety..He kept giving me more since the dose wasnt working..But then it all hit my system
at once..They had to give me Narcan to reverse the overdose.

She said I could have anesthesiologist with me which could maybe help me.
Not sure thoght if my insurance will cover that.

I know all insurances are different Im on medicare.
But jsut wondering if anyone else had an anesthesiologist and insurance covered it.
I know theres people out there that dont have any sedation at all.
I have already messaged my insurance about it.

mediCARE covered everything on mine. there was an anesthesiologist and propofol was used. I remember the medication in particular b/c it was no getting woozy and going under it was immediate full 'lights out'. after the procedure I remarked to the anesthesiologist 'how could anyone claim Michael Jackson could have self administered that stuff?'. same thing for my brother on a different mediCARE plan in another state.

 

[Dznypal]

thanks for the great tips
I have to clarify that I had my last one in 2018 so I mis typed that I was due for the next one in 2023
Im glad you were able to have an anesthesiologist
Thats who I needed--both my DH and myself had the same dr he had 3 I had 2 and neither one of us had an anesthesiologist--for me it was an nurse who gave me the fentanyl cause I remember talking to her about it before she gave it to me
actually I also had midazolam and Benadryl so I should have been out cold.
I still dont have a good feeling about this.
This also give me panic attacks just thinking of having to have this done again not sure what they can do for that.
Thanks all

 

[TippyThomas]

All of mine have been done with an anesthesiologist and insurance has covered it each time with no problems.

 

[tvguy]

I know theres people out there that dont have any sedation at all.

 

[tvguy]

Or are you a good candidate for other types of tests like the cologaurd?

OP is on a 5 years schedule instead of the normal 10 years. I suspect OP has health issues that rule out cologuard.

 

[Dznypal]

Actually the 2 that I had they removed 1 polyp each time
I’m already worked up about this and I don’t even have a new dr for it
My new PCP said she could recommend 2

 

[Kooks and Bay Bay]

OP it seems like you had a quack before.
I would go with a different group this time.
They don't usually give you all that stuff just some propofol.
It could also be that since this was 7 years ago they used different meds than they do now.
My mom has had one 4 times in 2 years. The most recent being a couple weeks ago. (don't ask the place went overboard but she just got a report that said she can wait 3 years).
Hers have all gone fine and other than getting through the prep she's always saying how great it is to have the propofol and be lights out and then be awake and not groggy.
I had an endoscopy a few years ago and felt the same.

 

[tvguy]

Actually the 2 that I had they removed 1 polyp each time
I’m already worked up about this and I don’t even have a new dr for it
My new PCP said she could recommend 2

The polyps are why you are every 5 years. My wife is in the same boat.

 

[LuvOrlando]

Some people are resistant to certain medications which is why you got too much, it happened to me once among other times the everyday medicine didn't work so now I get general every time. I think you should check on the actual name of the medicine because Dr's in the office use another kind of light stuff which is different, the medicine you mention is what I get now with an anesthesiologist in the room, I never heard of it being given by a reg Dr so I'd double check. Maybe it was a nurse anesthetist? Even so it is easy enough to say, "If I do not hear Dr in front of the anesthesiologist name I am leaving." For me, first test I woke up screaming, another time a Dr held me down and I woke up covered in bruises and another Dr gave me so much I kept passing out all day like I had narcolepsy. I am high risk but skipped a number of years because of fear over my experiences. Now I go under general anesthesia with an anesthesiologist and it is uneventful, I don't even get migraines from it, this is better.

Process is Dr needs to book time in a hospital OR and sometimes they get prior approval for general but some times the Dr moves me through and it is a game-day decision from the anesthesiologist that comes to see me, they get final say and insurance doesn't fight it. Your only chance to talk to anesthesia dept ahead of time is when you get that phone call about allergies and such 2 days or so prior to the event, this is your chance to say you have bad reactions in the past. Thing is I repeat over and over my terrible experiences that if they don't give me something other than whatever I had before I'm going to get up and leave. Insurance has covered every time.

Get an estimate ahead of time it will force them to pay attention.

 

[AussieFan8]

I once chose to have a sigmoidoscopy without anesthesia. The procedure itself was relatively painless, but the part where they introduce air into your bowel was not comfortable, and I have a pretty high pain tolerance. I was just about to say "I may need anesthesia after all!" when they finished with the air and did the procedure. So I will say it's manageable, but I likely would not choose to do that again. My doctor told me he has a patient who never gets anesthesia for hers, but that we were the only two people he'd had who had opted for none.

 

[disney212]

I have crohn's so lots (close to 30) in the last 10 years. Twilight does not work on me so my GI would admit me as an outpatient and do mine at our local hospital to do mine under full anesthesia. I have a lot of health issues so that may work for you too.

 

[KPeterso]

I had mine under general anesthesia. I have serious medical anxiety and cannot be awake for something like that (had my cataract under general too). Anathesiologist was there and actually was the one who finally got an IV into me (tried by all the best nurses in about 5 different spots with no success).

 

[tvguy]

I once chose to have a sigmoidoscopy without anesthesia. The procedure itself was relatively painless, but the part where they introduce air into your bowel was not comfortable, and I have a pretty high pain tolerance. I was just about to say "I may need anesthesia after all!" when they finished with the air and did the procedure. So I will say it's manageable, but I likely would not choose to do that again. My doctor told me he has a patient who never gets anesthesia for hers, but that we were the only two people he'd had who had opted for none.

I started to wake up in the middle of my last one. No pain, just uncomfortable. They apparently upped my anesthetic to put me back out.

 

[tvguy]

I have medicare. Just had this done 2 weeks ago. It was covered by insurance with an anesthesiologist giving the sedative, which is just a twilight sleep.

They have always put me out, no twilight sleep. So it is at least an hour afterwards before you are out of it. I had a cardioversion this year and they used twilight sleep that was interesting. I was out for about 10 minutes, and fully recovered in 5.