Prevention and Treatment–The Grey Area
Medicare beneficiaries, 65 and older are especially susceptible to colorectal cancer, also known as colon cancer.
For this reason, this particular age group is highly advised to undergo regular colonoscopies.
Under the new health care reform most preventive services like colonoscopies are paid for by Medicare Part B at no cost to the beneficiary. Medicare Insurance Supplements provide zero out of pocket costs, but under this new benefit preventive screenings can also offer the same advantage. When it comes time to pay for colonoscopies, however, some Medicare beneficiares have discovered an exception to this new benefit.
If one undergoes the preventive screening for colorectal cancer and doctors find and remove a polyp, the preventive screening is considered a treatment. Polyps are asymptomatic but can be an indicator of colon cancer, so detecting these tissue growths is imperative and can only be done so with a colonoscopy. In this case some private insurance companies say this puts the burden of paying for the procedure on the beneficiary, because removing the polyps is “treating” the issue, and treatment is not part of the deal for prevention services covered by Medicare. Depending on whether or not you have a Medigap insurance plan, these out of pocket costs can be detrimental to your finances. Consult your private insurance provider or a Medicare Supplement Insurance Agent to find out the cost structure of your preventive screenings for colon cancer.
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