opinions

Kuzyk: Medical co-pay required before insurance-covered colonoscopy

Posted 5/25/21

I want to inform people about a co-pay policy being used by a medical office in the Valley.

I am a 59-year-old, five-time cancer survivor living on SSI disability. I barely make enough to survive, …

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opinions

Kuzyk: Medical co-pay required before insurance-covered colonoscopy

Posted

I want to inform people about a co-pay policy being used by a medical office in the Valley.

I am a 59-year-old, five-time cancer survivor living on SSI disability. I barely make enough to survive, plus I am trying to raise my four grandchildren ages 5, 7, 8 and 12.

I was scheduled for a colonoscopy, due to rectal bleeding, at Arizona Digestive Health in Mesa. This test uses a colonoscope — which is a flexible tube — to find signs of inflammation, ulcers, polyps or tumors. Doctors also can remove abnormal growths, take samples of the tissue to biopsy and check for other signs of disease.

I have good medical insurance and Medicare. The Affordable Care Act requires private health insurers to cover recommended preventive services such as colonoscopies without any patient cost-sharing.

Medicare covers a colonoscopy every 120 months — 10 years — for most people, and once every 24 months I have a high risk of developing colon cancer. My Key risk factors include blood in my stool, a history of renal cancer, inflammatory bowel disease and having had polyps removed in the past.

Before I was to undergo this colonoscopy procedure, my doctor was to provide all the necessary information about preparing for this test. Learning about what to expect during a colonoscopy procedure should be a common part of the conversation between doctors and patients. I did not.

I was assured my insurance would cover the procedure in full. The fact of the matter is like myself, patients rarely hear much about what to expect to pay for a colonoscopy before the procedure.

A day or so before my scheduled colonoscopy, Arizona Digestive Health called to tell me there would be a $150 up front fee. I told them I was on SSI and could not afford that and could I make payments? Nope, cash up front. Be warned.

Editor's note: Andrew Kuzyk is a resident of Mesa.

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