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Just do it... yourself: At-home colorectal cancer screening

March 12, 2019

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James Richter, MD, Contributor

James Michael Richter, MD, is a Physician at the Massachusetts General Hospital and Associate Professor of Medicine, Harvard Medical School in Boston, Massachusetts. He received his undergraduate degree from The University of Texas at Austin and … See Full Bio
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March 12, 2019

“The Affordable Care Act mandated that insurance plans cover CRC screening tests, including colonoscopy, in full, with no out-of-pocket cost to patients. However, coverage does not apply to colonoscopies that convert from screening to diagnostic when a polyp is detected and removed during the procedure. And coverage does not apply to diagnostic colonoscopies after a positive CRC FIT or DNA screening test result.” So typical of the US health system, tell people it’s so very important for them to get a given procedure, then Congress can’t be bothered to amend Medicare and/or draft legislation that requires all health insurers to cover the entire cost of both screening and “diagnostic” aspects of the procedure.
My former insurer called polyp removal & biopsy “medical treatment” and said that meant the cost went towards the deductible. So someone w/that insurance could undergo a colonoscopy and end up owing whoever does the polyp removal and biopsies thousands of dollars because OF COURSE, the US health care system charges far far more for performing those services then say, those same services cost in Canada, or the UK, or the EU, Norway, Sweden, Kuwait & who know where else.

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