Looking to get my out of pocket costs for a colonoscopy and endoscopy.
Based on specific plan information, preventive routine colonoscopy and endoscopy services, performed in-network at covered at 100%. However, if these services are considered diagnostic procedures, then a $300.00 copayment applies, in addition to a $1250.00 annual in-network deductible.
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 be considered 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)
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.
Thank you !
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