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Be informed, ask questions

Tuesday, September 1, 2015


More Americans are insured now than ever before due in large part to the Affordable Care Act (ACA). As a direct result of the ACA, in fact, screening colonoscopy is part of the preventive coverage offered by health plans; it will also be a critical component of the American Cancer Society’s goal of reaching 80% of the population screened by 2018, which could prevent about 200,000 deaths.

In providing a screening as a preventive service, one may assume most charges are covered. However, the consumer must be proactive and ascertain what charges will be incurred and what the health plan will actually cover. Once you have scheduled your screening, it is necessary to confirm the costs with your doctor and then contact your insurance carrier to determine what your financial responsibility will be.

Some costs consumers need to investigate include consultations pre and post procedure. Facility fees vary substantially from physician office to ambulatory surgery centers to hospitals; whether the facility and the provider are in-network need to be confirmed. Prep kits, pathology and anesthesiologists are a few more costs that may or may not be covered.

Current trends in the health care industry that are utilized to keep costs down require consumers to be advocates and ask questions. “Free” does not always translate to no out-of-pocket expenses!

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