As part of the Affordable Care Act, routine/screening colonoscopies are covered in full. We all agree that early detection saves lives!
You may have seen ads recently for different home screening tests for colon cancer. These tests are non-invasive and require no special prep or need for time off. The test is performed at home, sent to the company via mail and a report is sent back to the patient once the results are determined.
If you take one of these home tests, and you receive positive results, you will still need to have a colonoscopy to find and remove the precancerous or cancerous lesions. However, because you now have a “diagnosis” of abnormality from the home test, the colonoscopy is not considered a screening. Your procedure will be coded as “diagnostic” which will result in cost sharing, ie; you will receive a bill from your provider.
It is a personal choice how you want to screen for colon cancer, but it is important to be aware of any out-of-pocket costs that may occur if you do opt for an at-home test.
Please contact me directly with any questions and I am happy to help.
Paula Green
207.523.0065
pgreen@acadiabenefits.com
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