My doctor ordered a screening colonoscopy and I am 45. Does my plan vover this and how much is my out of pocket cost? Is this considered preventive care?
Here is some information to help explain the difference between routine services and those that are diagnostic. Routine can also refer to a service that is preventive. The same test or service can be either routine or diagnostic depending on why it’s done. The cost for the service may change based on how it’s defined. (i.e. colonoscopy, mammogram, check-up)
Routine care: includes immunizations, lab tests, screenings and other services intended to prevent illness or detect problems before you notice any symptoms. The right preventive care at the right time can help you stay well and could even save your life.
Diagnostic medical care: involves treating or diagnosing a problem you’re having by monitoring existing problems, checking out new symptoms or following up on abnormal test results.
Be sure to ask your doctor why a test or service is ordered. Your benefits can be different for routine services versus diagnostic services. By asking your doctor why a test or service is ordered, you will know whether to expect the claim for the services to be covered under your routine services benefit or your diagnostic services benefit.
I will also send you a direct message providing more details regarding your specific coverage.
I have the same question. I was told the new recommendations is 45yrs for colonoscopy as a routine exam/procedure. Any help would be great.
This thread contains some useful guidance regarding colon screening services.
Colon Cancer Screening Guidance
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