• Action 9: Patients expecting free colonoscopies surprised when bill comes

    By: Jason Stoogenke

    Updated:

    CHARLOTTE, N.C. - Colonoscopies can catch cancer early and save lives.  

    But, ever since the Affordable Care Act (ACA) went into effect, there’s been a lot of confusion about which ones are covered 100 percent and which are not.

    The ACA says, if you're between 50 and 75 years old, you're entitled to a free colonoscopy every ten years.  There's not even a copay or deductible.

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    But, if you need a colonoscopy more than every ten years, your insurance can bill you.    

    So Action 9 checked with four major insurers in the Charlotte area: Aetna, Blue Cross, Cigna, and UnitedHealthcare.  

    For the most part, all four expect patients who need follow-up colonoscopies to pitch in.  Many refer to it as "cost-sharing."

    Medicare covers more.  In many cases, it covers colonoscopies 100% every two years, instead of ten.   

    The average colonoscopy costs about $2,000 to $3,000.  The average deductible can be anywhere from $0 to more than $1,000. 

    UNCC health professor Michael Thompson told Action 9 patients could end up having to pay "up to the full amount if it's a high-deductible plan because it probably won't reach the amount of the high deductible...it could be several $1,000s." 

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    But colonoscopies are so important, don't skip them.  

    Dr. Alex Krist is with the U.S. Preventive Services Task Force.  It isn't a government agency -- even though the name sounds like one -- but it played a big role in the ACA.  

    "We know that colon cancer screening saves lives. We also know that only 60 percent of Americans who are recommended to have screenings get screened," Krist said.  

    "Colorectal cancer screening saves lives. Colorectal cancer is the nation's no. 2 cancer killer, but it doesn't have to be. Recent guidelines recommend screening start at age 45 for those with average risk. Visual screening tests, like colonoscopy, can even prevent cancer when doctors remove pre-cancerous growths (polyps) during the procedure. Several at-home, non-invasive screening options are also available. Individuals should talk to their own physicians about the test that is best for them. When caught early through screening, colorectal cancer is easily treated and the survival rate is over 90 percent," a Colon Cancer Coalition spokesperson emailed Action 9.

    Natalie Speidel -- a survivor, nurse, and big believer in colonoscopies -- told Action 9, "I see colonoscopies as so much easier than going through having cancer or going through chemotherapy."  

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