Wellness

[Lipstickdiva]

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@phoenixbrd wrote:

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@Lipstickdiva wrote:

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@Krimpette wrote:

I'm surprised that the doctor's office would not have known in advance that the procedure would not be covered.  SMH.

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I contacted them after I found out and they said I was on the list to call because they found out that my insurance wouldn't pay for it when they ran it for pre-approval.  

Hmmm. "on the list to call".  A phone call when they found out would have been appropriate.

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@phoenixbrd, I just went for my consultation yesterday. The found out and said they were going to call me today about it not being covered.

[Lipstickdiva]

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@KatieB wrote:

Is this thru Medicare or insurance you have from work?

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@KatieB, insurance I have through DH's employer.

[Bri369]

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@Lipstickdiva wrote:

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@Bri369 wrote:

I'm really surprised.

Will the doctor's office give you a break on the price because you're a self-pay? 

Is the Cologuard an option for you?

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@Bri369, Yes there is a cost break as a self-pay.  

I don't want to do Cologuard because it is reportedly highly inaccurate, often giving both false positives and false negatives.  But even if I was okay with it, you have to get a prescription from the doctor for it and my doctor will not do that because she doesn't consider it an accurate test.  

I keep telling myself that if they find nothing, fingers crossed, I don't have to go back for 10 years so if I divide the cost by that 10 years, it's really not bad.  LOL      

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That's really awful. 

The thing that worries me about hospital procedures that aren't covered by insurance is what if something happens and there are complications?Is that covered by your insurance or are you a self-pay for everything that followed the original procedure?

[Zhills]

A colonoscopy is an endoscopic procedure?  

An endoscopy and a colonoscopy are two very different procedures.

Call back and be sure you understood them correctly!

[Lipstickdiva]

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@Bri369 wrote:

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@Lipstickdiva wrote:

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@Bri369 wrote:

I'm really surprised.

Will the doctor's office give you a break on the price because you're a self-pay? 

Is the Cologuard an option for you?

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@Bri369, Yes there is a cost break as a self-pay.  

I don't want to do Cologuard because it is reportedly highly inaccurate, often giving both false positives and false negatives.  But even if I was okay with it, you have to get a prescription from the doctor for it and my doctor will not do that because she doesn't consider it an accurate test.  

I keep telling myself that if they find nothing, fingers crossed, I don't have to go back for 10 years so if I divide the cost by that 10 years, it's really not bad.  LOL      

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That's really awful. 

The thing that worries me about hospital procedures that aren't covered by insurance is what if something happens and there are complications?Is that covered by your insurance or are you a self-pay for everything that followed the original procedure?

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@Bri369, that is a good questions.  I really don't know.  I didn't think to ask about that.  The rep. just told me that if they find anything at all that has to be removed, it is then automatically considered a diagnostic test and my insurance will pay.  I'd rather self-pay then have that happen though. 

[Bri369]

@Lipstickdiva 

When are you having this done?

[lovesrecess]

You need to tell us which insurance company you have...shame them!

[Lipstickdiva]

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@Zhills wrote:

A colonoscopy is an endoscopic procedure?  

An endoscopy and a colonoscopy are two very different procedures.

Call back and be sure you understood them correctly!

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@Zhills, I did question that and then I looked it up and sure enough, there are like 13 different procedures that are considered an "endoscopic" procedure and a colonoscopy is one of them.  I was surprised at some of them on the list.

[Lipstickdiva]

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@Bri369 wrote:

@Lipstickdiva 

When are you having this done?

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@Bri369, May 3.  Now I sort of wish I would have just had it done next week when they initially wanted me to come in.  

I really wanted to wait until after we come back from vacation in the event something is wrong.  But I make myself such a wreck over this type of thing that I should have just gone and gotten it over with.  I'm so ridiculous about this stuff.    

[Lipstickdiva]

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@lovesrecess wrote:
You need to tell us which insurance company you have...shame them!

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@lovesrecess, it's Medical Mutual.  But I can't really blame them.  It's more the employer since they picked this policy.  Other people have MM and this stuff is covered.  The employer could choose to follow ACA guidelines but aren't.