Colonoscopies are one of the many procedures that fall into the screenings recommended by the United States Preventive Services Task Force, and that have to be covered without copay by insurance companies under Obamacare. But say during that screening colonoscopy, your doctor found a polyp and removed it. That's pretty common, happening during screenings with about 25 percent of men and 15 percent of women. And when that happens, the procedure magically changes from a screening to a polyp removal, which means that you end up having to pay a good chunk of that bill.
With regulations issued by the government Wednesday, insurance companies can't charge you for removal of a polyp during what is supposed to be a routine screening. Here's what it says:
Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.There are other preventive services in the regulations that will have to be fully covered by insurance which are fairly run of the mill, recommended immunizations and such. But another very helpful and somewhat unexpected service has been added to the list of things your insurance has to pay for: both genetic counseling and evaluation for routine breast cancer susceptibility gene (BRCA) testing for "women whose family history is associated with an increased risk for deleterious mutations in the BRCA1 or BRCA2 genes."
So happy preventive health day. You might still dread the test, but at least you won't have to dread a big bill following it.