General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsMy colonoscopy on 12-20-11 cost me $1306.00 by the rules in effect for Aunt-Thumb Insurance.
Last edited Tue Oct 23, 2012, 04:36 PM - Edit history (1)
Under Obamacare it will be covered as preventative care. Try to stay awake people, plz
imanamerican63
(13,725 posts)sfpcjock
(1,936 posts)Mike C: "yeah, so somebody else will pay the $1306. That's a solution, I guess."
Me: "Not at all, Mike. If I progressed to stage III with cancer, then the ER would get a $20,000 bill for letting me die. You would pay that bill."
Patricia G: "Mike, Bob's insurance would cover the whole cost. Preventative care is covered. Yes, solution."
RockaFowler
(7,429 posts)We pay for insurance. Shouldn't that cover something?? My goodness these people are unbelievable. Like BC pills. I pay a monthly fee for my insurance. Shouldn't it cover prescriptions. It really is amazing that people don't understand that!!
imanamerican63
(13,725 posts)I had a mild heart attack in 2004 and had a insurance deny my claim, because it was pre-existing! In the end it cost me my business and I had to file bankruptcy! Then to top it off that same insurance was a fraud and had several complaints filed against them!
Best of luck in fighting those idiots and get healthy!!! My prayers go out to you!
freshwest
(53,661 posts)The person they disdain for not 'keeping up with the Jones' in their neighborhood, for eventually in some cases falling to the level of public assistance, could have avoided the loss with some reasonable level of healthcare. Children are disadvantaged as one or both of their parents perish from what could have preventive care, and may or may not become 'burdens' as these types refer to them. There is a silent 'holocaust' going on in many people's lives, but the lost productivity is never discussed, nor the damage to keeping families intact. Those who have not been without don't understand this; or maybe had other factors that prevented chaos. When one adds together the lack of employment, healthcare, education and proper environmental protection that many live under, it is no wonder that we have an underclass. Imagine that for generations, and we have a huge moral debt to pay those who have caught in that situation. Those who seek to demonize or discard those folks because they end up on the public purse, are simply living the lie that it can't happen to them as well. The arrogance they display is a cover for a deep seated fear that they are eligible to be brought down, too. In a conservative, that means never giving in to 'stay on the top,' to a progressive, that gives urgency to raising the bottom of society so that if one has a fall, it won't be down into the gutter. JMHO.
flamingdem
(39,308 posts)I can't wait to get mine, well not really but at least it will be free-ish. What about anesthesia, did you go for "twilight"
lpbk2713
(42,736 posts)NV Whino
(20,886 posts)Te hospital charged Medicare $12,000 for mine. The hospital down valley charged a friend of mine $4000. They didn't get that, of course, because they. Have a contract with Medicare. They each got about $486.
valerief
(53,235 posts)sfpcjock
(1,936 posts)Mike C.: "You're missing my point, which is my fault. Obamacare specifically does nothing to control insurance costs. They will hammer down payments by actual medical care providers to the poor and the elderly to shift funds to the private insurance pool subisidies. That's who will end up paying for the reduction to (sfpcjock). What won't happen is cost controls on the insurance companies or drug companies. While it's great that (sfpcjock's) out of pocket costs may go down (assuming he gets into an afforadable pool, which, given pre existing conditions, is still iffy-- he can get coverage but not at the cheap co pays and premiums people without those conditions will get in the non-subsidized pools-- he'll get insurance at the same rates or worse than he'd get today, but he'd be theorectically subsidized by the gov't). And still, that will only last until he qualifies for Medicare, and then his ability to get free preventive care will go down every year because the gov't is not going to continue funding preventive care for people they need to die ASAP to keep the system solvent. But, good luck to yas!"
(he goes on...)
Mike C.: "If they were interested in fixing anything, rather than just add another concessionto the the private insurance system, they would have created Medicare for all. Now we'll never see it in our lifestimes unless they throw it to us as a bone in exchange for another world war."
sfpcjock
(1,936 posts)Me: "Mike, for one thing, instead of up to 30% "overhead" of private insurance, under Obamacare they can charge no more than 18% for non-medical expenses like giant salaries for greedy executives and data mining to cherry pick the pool before they offer us insurance. That will help a lot. For another, Obamacare budgets $80 billion for creation of community clinics and training of more professionals. That will result in more cheap preventative care and screenings rather than expensive death care that hospitals pick up and add to your costs. Thirdly, we have in the U.S. at least two working models of cheaper, more efficient care: the Cleveland Clinic in Ohio, and the Mayo Clinic in Minnesota. They know how to meet the doctors at the beginning of care and to use lists and computers to minimize duplicate testing. It's really much cheaper. Finally, as you said, Medicare Part E for Everybody is the way to go. Realize that Obamacare, like Romneycare in Mass. is the intermediate to get there. Probably is no other way, and we need it eventually "
begin_within
(21,551 posts)Obamacare has mandated that preventive screening, such as colonoscopy and mammograms must be covered by the insurance company and the patient has no copayment. I recently had a colonoscopy and had to pay nothing. The bill shows that I would have had to pay $3,598 if I had no insurance, since my colonoscopy included removing 3 polyps. And yet I paid nothing, other than my monthly premium, and I credit that to Obamacare.
There is a slight catch, though, and it depends on how the colonoscopy is coded in the billing. If it is just a "screening colonoscopy" as a routine matter, then there is no copayment for the patient to pay (and that is mandated by Obamacare). However if it is a "diagnostic colonoscopy" meaning it was done because colorectal cancer was suspected, then that could require a copayment, depending on the terms of the insurance policy.
And if polyps are removed, and sent to a lab for testing to see if they are cancerous or pre-cancerous, there could be a copayment for the lab services, even if it was just a "screening colonoscopy." Some patients have received surprise items on their bill for lab tests on polyps, even when they went for purely a screening colonoscopy. In my case there are 3 charges for $130 each on my bill, but for some reason the insurance company did pay for those. But I have read in articles about this that some patients are surprised by their bill when they expected the procedure to cost nothing.
Because of the requirement by Obamacare that insurers pay for the screening colonoscopy, and the fact that colorectal cancers have no symptoms at all in the early stage, and it is one of the most easily cured types of cancer, there is absolutely no reason for anyone over 50 to not have a colonoscopy, unless they have no insurance. For people without insurance, there is a program that they can get one done for a flat fee of $950 no matter where they are in the U.S. http://colonoscopyassist.com/
sfpcjock
(1,936 posts)BlueStreak
(8,377 posts)Some insurers are taking the position that if there are any lab tests as a result of a screening colonoscopy, then the entire procedure is therefore not a screening, so they make you pay the entire cost (or put the entire cost to your deductible, more accurately).
I think there will have to be some lawsuits to stop that abusive practice. It is not uncommon for a screening to find polyps that need to be tested. That doesn't alter the fact that the scope was a screening exam.
I have a screening coming up in a couple of weeks. I called Anthem and at least on my policy, they do not take that abusive position. But it is a good idea to ask in advance.
begin_within
(21,551 posts)The colonoscopy itself should be covered, no matter what. From the few people I talked to about it, it all depends on "how it gets coded" in the billing process. The law needs to make clear, because a lot of people have been tripped up by unexpected bills.
BlueStreak
(8,377 posts)that proctologists are the problem here, coding it improperly. They do these tests all day long. They certainly know what iss up, and they know that a screening should be coded as a screening.
If patients are being charged, I bet in 99% of the cases, the insurance company changed the coding so they wouldn't have to pay for it.
Mariana
(14,854 posts)It was still covered, but we had to pay a few hundred dollars for it for the very reason you said: "It's not preventative if they found poyps and removed them." WTF?
slackmaster
(60,567 posts)I have a bad family history and am on the 5-year plan for colonoscopies. My next one will be due in March 2013.
ETA the out-of-pocket cost of mine have been about $1,600.
sfpcjock
(1,936 posts)They paid like half. 3 years prior they paid the whole tab, but it's a lot of dough to have to put down at once. My medical provider actually gave me a year to pay by not sending it to collection after 3 months, so you are even more correct.
nini
(16,672 posts)I didn't have to pay the co-pay. That was in '97.
Wow.