That’s why they’re called companies, not charities. They’re in this game to make money and can care less about you. If they say they care about you, know that they lie.
To those that complain about insurance, why don't you open an insurance co and run it in a way you feel to be fair? If so many people are being " robbed " , you should have an easy market no? Also, to those that feel companies are bad, do you have any $ invested in a 401K or other retirement accounts? Do you want those companies to do well and grow your $ or would you rather your $ not grow? If any of you are not self employed, do you want the company you work for to do well or would you rather they lose $ and close?
Why does US Healthcare and Health Insurance system feels like a big game of monopoly or Wheel of Fortune, everytime you need it, it's a game of random whether you're gonna get covered or not??
The Medical Industrial Complex likes to keep us confused like that. Basically most insurance only covers one doctors visit (in the network) everything else God only knows what's covered or not. Most employers here offer medial insurance but you still take out a portion out of your check (depending on coverage). Then you pay out the a$$ in taxes out of each pay check. We spend twice as much on taxes alone for the Medical Industriak Complex than any other nation that has universal health care like Canada or the UK. If you have a medical emergency where you need an ambulance that'll set you back a few thousand dollars. The sad part is those ambulance EMTs are getting paid minimum wage now and some are volunteers. A medical helicopter is game over since you're pulling a second mortgage on your house of over $100,000. Medical debt here is a major reason why Americans go bankrupt it's sad.
@Amanda Ohrstrom if people would do the research, they’d find you to be correct. Going further, capitalism red and blue is more like right wing and less right wing.
@Thinblue Line There is no basic coverage for all, that's why we need Medicare for all. (In Cali we do have coverage for those who can't afford insurance and it covers more than regular insurance). The country needs to do the same.
It's not if a polyp is found. Once a polyp is discovered, it becomes categorized as a "diagnostic" colonoscopy and your insurance company will charge you for the procedure, even though the "screening" test (Cologuard) is FREE, per the ACA Mandate.
@@theman7095 It happened to us. My husband's insurance company told us that the colonoscopy was free so he had it done but they found a tiny polyp that turned out to be nothing. But because they found something, the insurance company didn't have to pay for any of it and we had to pay several thousand dollars we didn't expect. No merry Christmas for us.
Wrong. The problem is Cologuard, which has a high rate of both false positives and false negatives, making it worthless. The insurance company doesn't want to pay twice for one test, so you should get the test that works - colonoscopy. Your fault if you go for a scam test that doesn't work. Case in point: woman was not positive despite Cologuard's pos result.
@VA It is Cologuard's fault if the "screening tool" they are selling doesn't work, you have to have the colonoscopy anyway, and it costs you more money. They might just as well send you the "positive" paperwork without bothering to do the test, and I wouldn't be surprised if that is exactly what happens. You're the "low logic thinker".
@@robinlillian9471 We're talking about two totally different issues. The story wants to paint ColoGuard as the bad guy. Regardless of ColoGuard's success/fail rate, insurance companies are taking the opportunity to deny coverage because the care provider is coding the procedure as diagnostic vs routine screening. ColoGuard has nothing to do with that.
@@robinlillian9471 yeah, better to avoid these screening tests if you have absolutely no reason to suspect you might have a problem, cause more often than not you will have a false positive and then will need to have an unnecessary invasive procedure. If someone does suspect they have a problem then it's better to just have the colonoscopy since it's more reliable.
The same thing happened to my partner. He received a positive result from the home testing kit and called to schedule a colonoscopy ASAP. The doctor told him that because he had a result from the home kit, the colonoscopy will cost a few thousands dollars. He decided to go ahead and pay it and found out subsequently that he had stage 4 colorectal cancer. I don’t think the blame should fall on the home test kit because without it he might never have been alerted to go for the colonoscopy. I think the insurance company need to re-examine their policy.
I would never waste my time with a product with high rates if false positives and false negatives. A false positive might cost you money, but a false negative could cost you your life.
Your comment made me curious so I looked it up: the false positive rate (likely followed by a colonoscopy) is *13%* and the false negative rate (possibly followed by cancer developing silently) is *8%.* Both seem very high.
@@desmond-hawkins It's higher than that number. Cologuard claims this - however, several studies done on Cologuard patients with subsequent follow up colonoscopies found that 99% didn't actually have cancer - and another study found that 94% didn't actually have cancer.
My copay for a physical is $150. That's two months of groceries. I'd rather eat than see the doctor. I'll continue to wait until I have better insurance.
@@bikeman1x11 if you listen to you doctor about fruits and vegetables you're doing it wrong, "cholesterol is bad" was 1950s fear mongering .. the sheeple babyboomers bought it and 1971 they made it the official standard american or western diet 1971 is when americans started getting obese at a rapid rate.. A humans natural diet is a meat based diet at lest 90% of your diet should be animal consumption Most plants are not digestible you're not a herbivore you can't ferment them... you don't have the physical organs to do so
Wouldn't the US benefit from encouraging and helping patients with preventive care than waiting until one is tested positive for cancer (or other life threatening conditions) thereby costing more time and money for all stakeholders?
This feature makes it sound like one person had a problem but now it's all resolved, thank god. Truth is, medical insurance and medical billing in the U.S. has become so convoluted and predatory that the average person risks bankruptcy or damage to their credit rating just by being alive.
@@GregariousAntithesis So why don't you open up an insurance co and run it in a way you feel to be fair? If so many people are unhappy with the current business model, you should have an endless supply of customers.
@@bobroberts2371 no how about we go back to the way it was before Nixon when healthcare became about profits. Before that healthcare was not for profit. Apparently you have no clue how hospitals got their names like Presbyterian, and Catholic. Make healthcare about the hippocratic oath again not the hypocrite that it has become.
@@GregariousAntithesis said " no how about we go back to the way it was before Nixon when healthcare became about profits. " I'm all for that as long as you agree to move back to the med technology available in that time frame. Also, I'm well aware of how hospitals were started.
This happened to me. If I knew it had a high false positive rate and I would have to pay for the colonoscopy, high deductible insurance, I would have thrown it in the garbage.
The false positive rate is actually less than 5% for patients 45-49, 8.5% for those 50-65 and 13% overall. Colonoscopy misses as much as 11% of cancer (5% on average) and 40% of polyps Dr dependent. Now throw in the risk of complications associated with colonoscopy and you'll have a whole new perspective. Any positive Cologuard test is FAR better than a false negative colonoscopy or a complication.
"Many can get a colonoscopy at no charge if they're over 45" - yeah would be nice for those of us who have a family history and increased risk of getting colon cancer earlier than that. God forbid I have a reasonable concern that I could have colon polyps or even tumors at 30. Especially considering that the age of people with colon cancer is trending downward at an alarming rate. Health care in the country is a joke.
This is not true. The incidence rate of colorectal cancer in age groups below 30 remains at less than 4 in 100,000 population. Once you reach age 45 the rate rises to over 30. That is why screening is free for those 45 or over. Health insurance companies do cover screening for people under 45 with high risk due to family history.
@@meinempanadas I've read several studies that conclude that there is a 7.5% increase in incidence of colorectal cancer in the 20-29 age group. We don't know why this is happening, but the trend was observed between 2004 and 2016. What's more is that it could be even higher than that, as it's been about 5 years since the last data was collected for this particular study. And, no, my insurance provider was well aware that both of my parents died of cancer, one of which died of colorectal cancer. They still refused to cover a colonoscopy, despite me having clear symptoms of colon cancer. Thankfully, I only had benign polyps, but the risk was still there that they could have developed into cancer before I turned 45. It's unpredictable, but the oncologist said that some of them were large enough to be concerned about developing into malignant tumors, and it was a good idea to get screened when I did so that they could be removed before that happened. Here's a link to the abstract of that study, by the way: gut.bmj.com/content/68/10/1820 This study was done in Europe, in interest of full disclosure, so fair enough it could be some kind of exclusively European phenomenon. I swear I found one for the US that had similar findings, but I was unable to retrieve it. So, I might have been confusing a different study for something else with a second American version of this study.
@@danieltaylor4185 Studies outside the US are not relevant to US health care. The World Cancer Fund doesn't even list the US in the top 20 countries for colorectal cancer. The numbers in the US have steadily decreased, not increased.
@@danieltaylor4185 Yup this is true. I know someone who both parents died to lung cancer, but they said she can’t get screened until she’s 50. Both parents died in late 30s to lung cancer. That’s the joke of USA healthcare industry.
@C C Yeah, wish I could. Our "representatives" don't seem to care enough to put in a real health care system so I guess we get to suffer until the previous generation of politicians die of old age and we can finally get something done for once.
In insurance company talk, you're getting two colonoscopies, one after another, so the second one (the real colonoscopy) is looked at as unnecessary. To avoid any issues and fighting, just do the regular colonoscopy and forget about Cologuard. Everyone hates prepping for it, but if it ends up avoiding thousands of dollars in bills, just go that route.
Over 80% of the users of Cologuard are negative and able to skip an invasive procedure that doe's come with a risk of complications. Not only that but colonoscopy does not always find cancer and polyps that are there.
@@carlpahnke8992 I would say go with the colon guard if you refuse to do the colonoscopy but I don’t see why not also do the colon guard if you don’t have any symptoms or no family history.
A colonoscopy after a positive test whether it be Cologuard, or a FIT test is not looked at as unnecessary, it is now looked at as a diagnostic test instead of a screening, and insurance companies will typically fully cover a screening colonoscopy, they will not fully cover a diagnostic colonoscopy.
@@carlpahnke8992 Cologuard only detects 42% of large polyps, and it can't remove them as is done during a colonoscopy. After I had 2 positive FIT tests followed by a completely negative colonoscopy, no polyps, nothing, I'm not sure how I feel about these alternative tests.
Most Americans have been able to get flu shots, Covid Vaccine and other things for little or no money. Most insurance companies are pretty reasonable and you do get a tax break when you take for this care.
@@robertagabor3736 . Per capita a US citizen pays about twice that paid by a person in the UK. For that extra, they get healthcare that doesn't cover everybody and ranks lower in world rankings for quality of care.
You are actually being raked over by the Government. Get government out of health care watch it become affordable again. Health care is not better today.
Ms. Christy, you are taking a huge risk. I am healthy, but took a fall that landed me in an emergency room one night. So glad I had medical insurance or I would have had to delay my early retirement!
My husband is 45 and his doctor wants him to have a colonoscopy for screening. However, after calling the insurance company I now have learned that he would have to pay out of pocket because they don't cover until 50. This is sad and ridiculous.
@@AC-ro6ib that is because of your western diet of processed meats, plants and junk food.. what did you expect to happen? Just eat your natural diet of Fresh NON processed meat and you would not have this problem... also on a meat based diet you would not be pooping massive leavings every day
Absolutely. Our healthcare system is evil but the way we eat causes a lot of our health problems. But I’ve learned people would rather take their chances with their health by eating any and everything and then blame the healthcare system when they profit from those choices. Eat more vegetables than meat.
The colonoscopy is covered , then you get billed for biopsies. The biopsies are not covered ,cost as much as the colonoscopy, and that cost comes from your wallet. The biopsies are overpriced. I paid over $700 for 2 biopsies. Just because Medicare says it’s covered ,it does not , you get alacarte charges.
ColoGuard is 92% accurate, an invasive colonoscopy is less than 50% accurate & cannot detect cancer until polyps are growing. At that point cancer has advanced. Someone has sold you a bill of bad goods. Stay well.
@@bobroberts2371 Ah, how naive. "Health" care was locked down in the 1940's. That's why you're thrown in jail for practicing without a license. How do you get a license? You maintain good standing with the medical board in your region. Which is controlled by the broader medical industrial complex.... which wants you doing things their way... See Morris Fishbein and AMA in 1920's. Rockefeller medicine as well.
@@msr1116 exactly. I decided not to take the test and the company is constantly ringing my phone even after I requested they stop the phone calls. They're like annoying vultures ⚠️
That is not true. While a profit is necessary to stay in business. Many medical therapies are from companies founded by well meaning researchers hoping to save lives.
You dont seem to understand that had you gone straight for a "screening" colonoscopy in the first place, as soon as the GI doc finds a polyp, it becomes a DIAGNOSTIC PROCEDURE and your insurance company bills you for the procedure. Screening tests like Cologuard are FREE under the ACA Healthcare Mandate. Diagnostic tests are NOT!
It’s not whining it’s warning people to look into this before they get the cologuard. Most people end up with a colonoscopy after the screening. Why waste the time, just get the colonoscopy. It may not cost as much if it is coded correctly. I was specifically told by insurance (Anthem) if I had not been screened with the cologuard ,I would not have had to meet my deductible plus some . They said the colonoscopy would have been a free screening.
It’s better than what millions had before that, which was zero coverage. Don’t like the current policies? Work to get rid of progress-blocking legislators. Here’s a tip: they are overwhelmingly Republicans.
Before the Affordable Care Act colonscopies were not free like they are today. They just aren't free if you precede the colonoscopy with a useless cologuard test. Just get the colonscopy.
Just for the record If you have a preventive colonoscopy and it finds anything you are charged because it was no longer preventive. So while you have the test thinking it covered as a preventive procedure you can wake up to a nasty bill.
I know it's a popular term but "preventive" isn't correct for any diagnostic procedure--you either have the condition or you don't. Having the procedure won't prevent you from contracting something later--it'll just (hopefully) detect it early if you do have it.
Correct. This happened with my husband’s colonoscopy. Insurance companies will do anything they can to reduce the amount they have to pay out, it’s really maddening!
Incorrect!! I had a polyp removed and tested. There wasn't an extra charge because it was found during a preventative procedure. Also the patient can go on their insurance carrier's website. Go to provider information. Medical policy bulletins and pull up the procedure. Ask your doctor's office for the CPT (procedure) codes, diagnosis codes and modifiers to see how everything is covered. You'll also see the codes that are to be used and you can pass them onto your doctor.
I've taken two Cologuard tests and am due for my 3rd. It's super convenient and is 94% sensitive to detecting early stage cancer in Stage 1 and Stage 2. It totally outperforms the $25 cheapie FIT test that does nothing but detect if you have blood in stool. And Cologuard is covered by the ACA mandate. I have Blue Shield of California and have never had to pay for the test. It's Free, with no co-pay per the ACA mandate and being included in the U.S. Preventative Services Task Force Colon Cancer Guidelines.
Cologuard detected my colon cancer. I had no symptoms. Years of doing the FIT test didn’t catch it because FIT detects only for blood, which I had none. Insurance companies don’t want to pay for anything. Your health is worth paying yourself. If nothing is found you have gained peace of mind.
@@leslieclaire Agree w/you ! I’m not being negative about cologuard @ all. I would rather do cologuard than to have to go thru the full colonoscopy procedure. Plus if insurance companies would pay for cologuard the insurance companies would come out ahead in my opinion. Save money and plus more ppl would probably get screened for colon cancer. Ty for your reply.
@@SchardtCinematic thank you, that's good to know. I let a Dr. talk me into having a Cologuard test sent to me. After seeing this story I have no intention of using it.
I got a positive stool test. My HMO charged me $1000 colonscopy because it was considered diagnostic surgery. I was eligible to get the same colonscopy for free as a preventive measure. The colonscopy was negative. I found out the day of the colonscopy that instead of the expected $10 copay they wanted $1000.
Even in this piece, they say that SCREENING for colon cancer should be covered by insurance. Let's go further and say that TREATMENT should also be covered.
I had a false positive with Cologuard. My physician said that 65% of the results of this test is either a false positive or a false negative. He said I should have never had it prescribed by my PCP.
Yep. Happened to me. Doctor never explained this could be the outcome of a positive test. Ridiculous! I had the colonoscopy, but the cost was high and I should not have been charged. This should be clear when deciding whether to use the test or just getting a colonoscopy.
Frankly, my own personal experience with the Cologuard test left me with two observations. 1. The test is so sensitive that it produces a significant number of false positive results. 2. A traditional colonoscopy isn't nearly as bothersome as I thought it would be. Going forward, I'll just skip to the colonoscopy and avoid the 10 days of worry over the positive Cologuard result.
A test's sensitivity has nothing to do with false positives. If anything because it is so sensitive you will get less false negative results because it is so good at picking up pathology
With a colonoscopy if they find no polyps, it's ten years until your next one. I just very recently had my second colonoscopy, and again no polyps, so once again I don't have to worry about another colonoscopy for 10 years. The Cologuard test has to be taken every 3 years after a negative test, and if you do test positive, you'll be getting a colonoscopy, and you'll be paying for a diagnostic colonoscopy that is not fully paid for by insurance as a screening colonoscopy is. Might as well just get a colonoscopy in the first place.
@GrumpyBoomer You are correct. I just got a positive result with Cologuard and I am extremely worry now. I don’t have any of the symptoms mentioned in the pamphlet so I am freaking out more now. I am working on scheduling a colonoscopy now. Were your colonoscopy results the same as Cologuard?
It’s sad how things are getting, a relative had those sent to him by his PCP, he never took that home test, thank God, the mere fact that the insurance company wouldn’t want to pay if you get a positive reading and the bills are on you was something i never thought about after seeing those commercials!
The solution: don’t let the insurance or doctor know you took an at home test Also it would have been interesting to know what the colonoscopy came back with vs the home test
This goes for any at home tests sent to you from Home Access Health Care (now known as PWN and owned by Everlywell) this place is awful and has had multiple PHI breaches they just sweep under the rug. -Sincerely, a former employee
@@robertagabor3736 Didn’t say it was. Just saying that kits from this company are just as sketchy and it’s basically the same as Cologuard. Cologuard is one of their biggest competitors.
Colonoscopy is not free. The Anesthesia bill is separate and if you don't have insurance you have to pay for the procedure unless you have medical or some other form of insurance. Still hoping and praying for an easier, less complicated screening test and more accessible to all people.
I went for a screening. I got billed because the doctor found two noncancerous polyps and removed them. Insurance said the doctor did not bill my test as a preventative screening. I got scammed but I had to do the "screening". I guess it's a preventative screening ONLY if the doctor finds nothing wrong.
This happened to me just yesterday! Several MONTHS ago I did the cologuard test, which came back NEG. Yesterday I got a bill for $695. I will be calling my insurance company and disputing this charge.
CEO just basically told reported that doing the bare minimum is OK because going over and beyond to inform customers that if they get a positive test and a colonoscopy is required there will be out of pocket cost because most insurance won’t cover it because it will be billed as out of network. if they were to pull all the old commercial or edit the old commercial to inform customers about the potential of them getting a positive results from the at home test and requirements for the colonoscopy test they will lose customers and in turn bottom line.
The problem isnt with Cologuard. And it has nothing to do with being "out-of-network". Any "at-home" colon cancer test is Free with no co-pay per the ACA mandate as one of the 10 Essential Healthcare Benefits, under Preventive Services. Cologuard is Free. The cheapie Fecal Immunochemical Test (FIT) is Free. (But it does nothing other than detect whether or not you have blood in your stool). - - - As soon as a "screening" colonoscopy detects a polyp, it becomes a "diagnostic" colonoscopy and your insurance company will bill you for the procedure.
Romario Hylton Are you saying the CG should be responsible for researching every insurance co / patient situation that exists ? They don't provide ins nor should they be held responsible for what an ins co does.
@@bobroberts2371 At the very moment yes. This present moment they know now that if a customer purchased a product and they get a positive result the customer would have to go to a doctor and get a colonoscopy. Upon getting the colonoscopy they will be billed as out of network and they would incur out-of-pocket cost. The reporter asked the CEO if it would be better for the company to remove the old commercial and air a new commercial with the new information that the company now have on customers who gets a positive result. He said now because Hearing new commercials with the new information would make customer not purchase the colon test kit.
@@romariohylton3963 So will you hold the makers of any medical test to the same standards as you want CG to be held to? If so, expect costs to spiral out of control as whole office blocks of researchers and lawyers would need to vet every possible situation.
I used this test and received a bill for over $700. I called my insurance company and they said the company that sent the Cologuard test never submitted the charge to them. My insurance company paid the full bill.
Same thing happens if you get a questionable result on a screening mammogram and they call you back for repeat imaging. The initial imaging is considered preventive and therefore is fully covered by many insurance plans. The second procedure is being done to diagnose a potential problem found during the first procedure, and therefore is no longer considered preventive, so it is covered differently by insurance. This is just how insurance works and something people need to understand. Just get a screening colonoscopy, folks. The procedure is not bad at all.
I am a colon cancer survivor, and I had really crazy experience about how American insurance companies "treat" the patients. Just 7 days after the intestine removal surgery, I was still weak, with the the stitches still in my stomach and the body bloomed like a mushroom because of continuous potassium IV in the arm, suddenly the insurance company cut the coverage, saying that once the hospital's meal type changed from the liquid to the normal, they couldn't provide any more coverage. Doctor told me that I could stay at they hospital if I would like, but without any insurance coverage, the "room charge would be $4,000 per night"!!!!! What an insane standard the insurance company sets up, just to keep profits from the patients???
I truly believe that's why Chadwick Boseman continued to work so hard while sick, he had to pay his medical bills. Both of my sons have crohn's disease and have had several hospital stays, colonoscopies, labs, and tried just about all the medications out to treat it. My oldest had an ileostomy for 6 months. Thank God we have medicaid. The only times I saw prices were when I received the medications. A single Stelara or Humaria dose is $24k. You can't afford to be sick. It's a blessing that you survived.
That is nuts. My mom died of a rare form of colon cancer even though she had a negative colonoscopy 2 years before . It couldn’t be detected because it formed a thin sheet of tumor in the lining of the intestine
@@gloriamontgomery6900 yes in that the initial tumor couldn't be detected, because the initial symptom was not from the tumor. Tumor was developed from a small polyp. In my case, typical symptom emerged first, unexpected pain in the stomach, which was not common pain but very "foreign" fatal pain, to the point that you would lose consciousness. In my case, tow polyps have already developed inside the intestine cells, which become tumors...doctor discovered them when I visited my doctor for the completely different matters, a severe burnt on my leg. But he immediately noticed that something was wrong because of a big loss of weight (due to blood losses).. More than 10 pounds lost in 10 months before the doctor noticed.
@@Mita7538 At that tine, is think it was Aetna. It felt crazy when they insurance company abruptly cut the coverage just because the hospital meal was changed from semi-liquid to the normal, from yogurt or jelly to a chunk of chicken meat! even when my stomach couldn't digest a meat!
Democracy through the constitutional process has produced Presidents: GW Bush, Barry Soweto Obama (who helped create this confusion in 2010), Donald Trump and the very confused pair we have today. If this is the best we can do in the last 20 years, then democracy is not working. We're not the only country with some doozie old folks, Vlad Putin and younger blackface wearing theater majors to the north.
I was warned by my insurance agent when I turned 65, they won’t cover the cost of both. One is a preliminary test (positive or negative) , a colonoscopy actually looks to determine true or false.
Because I'm on a blood thinner, I couldn't get a colonoscopy so my dr. went with the cologuard. When that came back positive (the test has way too often given false positives), I ended up getting a CAT scan instead of the colonoscopy. My insurance covered that with just the small fixed co-pay.
this is no longer true....Starting in 2023, Medicare, Affordable Care Act, and commercial plans will now cover, as part of preventive care and screening, a follow-up colonoscopy after a non-invasive stool-based test returns a positive or abnormal result for patients 45 years of age and older.
I always thought that was kind weird myself, what person would send a stool sample through mail?😐, but that still doesn't beat having kids receiving a 'Pet rock' toy through mail.😒
Cologuard is FREE per the ACA mandate of being a Preventative Service under one of the 10 Essential Healthcare Benefits. It is a "screening" test for colon cancer and is free with no co-pay. As with any other screening test, if one must have a follow up "diagnostic" procedure (such as colonoscopy), then their insurance company will bill them for that. You dont seem to understand the difference between a "screening" test and a "diagnostic" test. The former is FREE per the ACA mandate. The latter is a billable charge by insurance companies.
Just a note if you get a test from a company known as Home Access Health (now known as PWN and owned by Everlywell) throw it out. The company is a joke and very careless with your health info-sincerely a former employee
That's horrible. My doctor at my yearly exam required me to get this thing. Mine went negative, but to know that if it was positive I'd be charged 1900$.... I'm sure my primary care physician didn't know that; she would have told me.
The specimens are sent via FedEx 2-day Air in specialty clinical packaging. There are regulations that must be met to ship any biological substance. Shouldn’t be any risk of leakage if you know how to properly secure a lid.
Oh wow! That’s so ridiculous! Poor lady! I ,thank goodness, had a negative test but I still get grief from drs to get a colonoscopy and there’s nothing wrong with me!
My doctor said these test kits are basically a waste of time other than they help get people in for colonoscopies who might not otherwise. Some people put the procedure off for various reasons including fear , after having it done I can say it was no big deal , the preparation at home was the worst part , cleansing your system out.
We live on social security and a very small pension. We have Medicare and Tricare and we are totally covered but I really feel sorry for people younger than we are, because medical costs are outrageous.
This is great information. I was about to order a cologuard kit but now I am going to check with my insurance company regarding a follow-up colonoscopy and how they will handle the claim. Great job reporting this.
Everybody between 55 and 75 is screened for colon cancer is by the government in the Netherlands. Of course the follow up is paid by the assurance company. Its much cheaper to treat people in the early state than later.
Technically it ‘catches all colon cancers’ if it gives back a positive result all the time, regardless of whether it’s actually positive or negative. It just includes all of the false positives along with it 😂😂😂
@@michaelk7194 OK Doctor what is more important, the sensitivity or specificity of a screening test? What percentage rates of each is acceptable when screening for cancer and why? Consider how many patients YOU see that flat out refuse lower endoscopy and the poor specificity of Hemoccult tests.
@@joedellaselva1251 That's hard when they prevent placental transfusion by clamping off your umbilical cord immedaitely after delivery, then pump you full of vaccines and bad food long before you ever had a chance.
My doctor told me that they prefer/insist to do a full colonoscopy for the first test in a person's life. After a negative test there, the screening test can be used.
He knew!! Just do the covered PREVENTIVE colonoscopy that your insurance pays for. Cologuard isn't for HIGH RISK patient. Know your family health history.
As soon as a Gastroenterologist finds a polyp during colonoscopy, it becomes a "diagnostic" test and the patient is billed. The problem with most people (and the woman in this video) is that she wasnt educated about how there is a difference between a "screening" test which is covered by the ACA Mandate to be free with no co-pay vs a "diagnostic" test. She would have been billed for the "diagnostic" colonoscopy regardless of what "at-home" test she took, whether it was the Cologuard test that is 94% sensitive to detecting colon cancer in Stage 1 and Stage 2, or the cheapie $25 FIT test (that Kaiser Health hands out) and does nothing but detect blood in stool.
I had a similar experience with my mammogram. I had requested my annual when I had some tenderness. I called my Dr. She checked and didn't find anything but changed my yearly preventative to diagnostic costing me over $600. Insurance is a shell game.
Imagine what a single payer system and actual capitalistic competition would do for the healthcare industry… Tired of the criminal cronyism. Mandatory insurance should be illegal
Without insurance, you really do have no protection. Get sick, lose your home because you can't pay, and start living on the street. Sure, that's a MUCH better deal. Hospitals charge people more when they don't have insurance, too. "Mandatory insurance" means no one has to pay big bucks for medical treatments, because everyone is covered by the government. Medicare is the cheapest insurance out there. The problem is that it only pays 80%, and even the 20% can bankrupt you.
I recently had a dental procedure that was covered by my insurance, but my dentist had to appeal the claim decision and prove that the procedure was necessary…all because the bill was high & my for-profit insurance didn’t want to pay. In the end, insurance paid as it should have since I had a covered procedure. I’ve never experienced this before & it really opened my eyes to how evil & greedy insurance companies can be.☹️
Nope. She doesnt seem to be very informed. All "screening" tests are FREE with no co-pay per the ACA Mandate. But a colonoscopy becomes a DIAGNOSTIC TEST as soon as the GI doctor finds a polyp and the patient gets billed for the procedure.
The problem with colonoscopies is you need a relative or friend to drive you home or to an area hotel after the procedure. Only screening of it's kind that is like that. They wouldn't let me take a taxi for instance unless I could prove I knew the taxi driver personally. Cologuard takes the travel and the nonsense out of the equation. I saved about $300 in hotel expenses alone. Us singles like the home remedy a lot better!
I've got the exact same issue, no one to drive me home afterward. So if I get a positive Cologuard test I'm stuck with knowing I MAY have colon cancer & can't do a thing about it. No thanks. Sometimes ignorance really is bliss.
Such a horrible situation with health insurance in the United States. Really stinks that life saving and life enhancing treatments and medication is dependent on a broken system.
The problem with a for-profit medical insurance system is that the way for-profit insurance companies make money is by avoiding paying out claims, whether for auto, home or business insurance. If people don't like this then they need to support universal healthcare and vote for Bernie Sanders.
The 2020 election is over. Even the Left doesn't seem to get that. Bernie Sanders is a doll, but he's old--and if he even runs & wins (doubtful against a Biden incumbency) in 2024 all his left wing, authoritarian followers will win, too. They're just as bad as Trump's cult or worse. MAYBE, they will vote in universal healthcare, but most likely they will refuse it to anyone who eats meat (probably that will be illegal), smokes, drinks soda, is overweight, or has any bad health habits. Results: probably very few would actually be covered. Oh, yes, and they want to eliminate your right to vote if you are a Republican, and put you in a concentration camp if you didn't get vaccinated (probably even if you have a health problem preventing it). So much for freedom and democracy--or common decency. I voted for Bernie the first time, but I wouldn't do it again, mostly because of how hateful & evil his "followers" are.
Yep and these are the same people who go all around the Internet telling other people and politicians how to live their lives and do their jobs. Call your provider before to get all the codes associated with any procedure you might need. Call your insurance company for an estimate of your out-of-pocket cost. Now you have a better idea of how you should move forward. No surprises if you do your research.
Health insurance companies are beyond ridiculous they are always looking for a way not to pay.
That’s why they’re called companies, not charities. They’re in this game to make money and can care less about you. If they say they care about you, know that they lie.
Sammy Warren: That's how they make the big bucks. They take your insurance premium money, and refuse to give it back to cover you.
That is all insurance, not just health, unfortunately. We would be a lot better off without it right up until we have that unplanned expense.
To those that complain about insurance, why don't you open an insurance co and run it in a way you feel to be fair? If so many people are being " robbed " , you should have an easy market no?
Also, to those that feel companies are bad, do you have any $ invested in a 401K or other retirement accounts? Do you want those companies to do well and grow your $ or would you rather your $ not grow?
If any of you are not self employed, do you want the company you work for to do well or would you rather they lose $ and close?
@@bobroberts2371 Good point. Business is about profit. Being ruthless is the way to survive.
Why does US Healthcare and Health Insurance system feels like a big game of monopoly or Wheel of Fortune, everytime you need it, it's a game of random whether you're gonna get covered or not??
Because the US is a country that is capitalism on steroids. Don’t worry, this country will collapse just like Rome did. Deservedly, so.
The Medical Industrial Complex likes to keep us confused like that. Basically most insurance only covers one doctors visit (in the network) everything else God only knows what's covered or not. Most employers here offer medial insurance but you still take out a portion out of your check (depending on coverage). Then you pay out the a$$ in taxes out of each pay check. We spend twice as much on taxes alone for the Medical Industriak Complex than any other nation that has universal health care like Canada or the UK.
If you have a medical emergency where you need an ambulance that'll set you back a few thousand dollars. The sad part is those ambulance EMTs are getting paid minimum wage now and some are volunteers. A medical helicopter is game over since you're pulling a second mortgage on your house of over $100,000. Medical debt here is a major reason why Americans go bankrupt it's sad.
The government could easily pay for everyone's healthcare, but they are useless. No matter who you vote for, big corporations win and you lose.
Fuking more suits outta bidness school in charge seeing this as some kind of bait and switch game and not life of death.
@Amanda Ohrstrom if people would do the research, they’d find you to be correct. Going further, capitalism red and blue is more like right wing and less right wing.
corporate healthcare isnt healthcare at all. its gross
Ah yes America, where getting and owning guns are way more easier and accessible than having basic healthcare.
@@DarkZerol not in NY
@Thinblue Line There is no basic coverage for all, that's why we need Medicare for all. (In Cali we do have coverage for those who can't afford insurance and it covers more than regular insurance). The country needs to do the same.
When will those that don't like the US health care system be opening up their own hospital or even a basic clinic?
@@bobroberts2371 Idt you can nowadays really... even if you wanted to
The system doesn’t really allow for it, imo...
AMA is one reason why
That’s ridiculous. The follow-up colonoscopy should be covered.
It's not if a polyp is found. Once a polyp is discovered, it becomes categorized as a "diagnostic" colonoscopy and your insurance company will charge you for the procedure, even though the "screening" test (Cologuard) is FREE, per the ACA Mandate.
Insurance companies are just white collar scammers.
YES!
and the box is white too! how evil is that...
@@theman7095 It happened to us. My husband's insurance company told us that the colonoscopy was free so he had it done but they found a tiny polyp that turned out to be nothing. But because they found something, the insurance company didn't have to pay for any of it and we had to pay several thousand dollars we didn't expect. No merry Christmas for us.
I wouldn’t trust a walking, smirking poop box in the first place.
If you’re having a conversation with a walking, talking poop box in real life, there’s something really, really wrong 😑.
Good point. Also what’s the point of the test if you still have to have a colonoscopy to actually confirm. This company is giving me scammer vibes.
plus you give up your DNA to a 3rd party which is sold to china
@Blah Blah how about just go to a doctor and get a colonoscopy and cut the middle man out who probably give you inaccurate information
@herpderpy 😂That was funny.
The problem is not with Cologuard...it's with the insurance companies. Shame on the Health Care Insurance industry.
Wrong. The problem is Cologuard, which has a high rate of both false positives and false negatives, making it worthless. The insurance company doesn't want to pay twice for one test, so you should get the test that works - colonoscopy. Your fault if you go for a scam test that doesn't work. Case in point: woman was not positive despite Cologuard's pos result.
@@sasachiminesh1204 ...it's a screening tool, not a definitive diagnostic tool. Apples and oranges. Shame on the Healthcare Insurance industry.
@VA It is Cologuard's fault if the "screening tool" they are selling doesn't work, you have to have the colonoscopy anyway, and it costs you more money. They might just as well send you the "positive" paperwork without bothering to do the test, and I wouldn't be surprised if that is exactly what happens. You're the "low logic thinker".
@@robinlillian9471 We're talking about two totally different issues. The story wants to paint ColoGuard as the bad guy. Regardless of ColoGuard's success/fail rate, insurance companies are taking the opportunity to deny coverage because the care provider is coding the procedure as diagnostic vs routine screening. ColoGuard has nothing to do with that.
@@robinlillian9471 yeah, better to avoid these screening tests if you have absolutely no reason to suspect you might have a problem, cause more often than not you will have a false positive and then will need to have an unnecessary invasive procedure. If someone does suspect they have a problem then it's better to just have the colonoscopy since it's more reliable.
The same thing happened to my partner. He received a positive result from the home testing kit and called to schedule a colonoscopy ASAP. The doctor told him that because he had a result from the home kit, the colonoscopy will cost a few thousands dollars. He decided to go ahead and pay it and found out subsequently that he had stage 4 colorectal cancer. I don’t think the blame should fall on the home test kit because without it he might never have been alerted to go for the colonoscopy. I think the insurance company need to re-examine their policy.
I'm so sorry. I hope that he will make a full recovery
I'm so sorry to hear this! Hope it's operable and treatable.
I would never waste my time with a product with high rates if false positives and false negatives. A false positive might cost you money, but a false negative could cost you your life.
Your comment made me curious so I looked it up: the false positive rate (likely followed by a colonoscopy) is *13%* and the false negative rate (possibly followed by cancer developing silently) is *8%.* Both seem very high.
@Desmond Hawkins i don't feel like this is high but I dunno
@@desmond-hawkins It's higher than that number. Cologuard claims this - however, several studies done on Cologuard patients with subsequent follow up colonoscopies found that 99% didn't actually have cancer - and another study found that 94% didn't actually have cancer.
My copay for a physical is $150. That's two months of groceries. I'd rather eat than see the doctor. I'll continue to wait until I have better insurance.
75 bucks a month for food? What are you eating? Ramen noodles for breakfast lunch and dinner?
@@wendys9587 unless he/she grows most of their food at home, 75 is a little low
@@wendys9587 a single person can eat cheaply and wisely - dollar tree has food
@@wendys9587 dog food two bags of dog food is 75$
@@bikeman1x11 if you listen to you doctor about fruits and vegetables you're doing it wrong, "cholesterol is bad" was 1950s fear mongering .. the sheeple babyboomers bought it and 1971 they made it the official standard american or western diet 1971 is when americans started getting obese at a rapid rate..
A humans natural diet is a meat based diet at lest 90% of your diet should be animal consumption
Most plants are not digestible you're not a herbivore you can't ferment them... you don't have the physical organs to do so
Wouldn't the US benefit from encouraging and helping patients with preventive care than waiting until one is tested positive for cancer (or other life threatening conditions) thereby costing more time and money for all stakeholders?
That is what colonoscopies are for.
how can you have preventive health care eating the food in stores and restaurants without organic vegan and bottled pure water?
@@michaelk7194 i get your point but veganism is a cult.
Absolutely. This test is safer, more convenient & 92% accurate. It can catch colon cancer early, which is key to survival.
You gotta be vegan to not get colon cancer. Being vegan sucks though, everything tastes terrible.
I'd rather get colon cancers than eat salads 24/7
This feature makes it sound like one person had a problem but now it's all resolved, thank god. Truth is, medical insurance and medical billing in the U.S. has become so convoluted and predatory that the average person risks bankruptcy or damage to their credit rating just by being alive.
“It’s kind of taking advantage of people”
So regular advertising, then?
This isn't CG's fault, they don't control the insurance industry nor could they foresee every issue with insurance that they don't provide. .
Its an insurance company rape as usual not the fault of a cheap pre screen product, you people are morons.
@@GregariousAntithesis So why don't you open up an insurance co and run it in a way you feel to be fair? If so many people are unhappy with the current business model, you should have an endless supply of customers.
@@bobroberts2371 no how about we go back to the way it was before Nixon when healthcare became about profits. Before that healthcare was not for profit. Apparently you have no clue how hospitals got their names like Presbyterian, and Catholic. Make healthcare about the hippocratic oath again not the hypocrite that it has become.
@@GregariousAntithesis said " no how about we go back to the way it was before Nixon when healthcare became about profits. " I'm all for that as long as you agree to move back to the med technology available in that time frame.
Also, I'm well aware of how hospitals were started.
This happened to me. If I knew it had a high false positive rate and I would have to pay for the colonoscopy, high deductible insurance, I would have thrown it in the garbage.
Sorry to hear it. Cologuard is a big racket. They get you for both the test and the colonoscopy later.
It is not free, it costs $500.00 and you are only allowed to have three (3).
The false positive rate is actually less than 5% for patients 45-49, 8.5% for those 50-65 and 13% overall. Colonoscopy misses as much as 11% of cancer (5% on average) and 40% of polyps Dr dependent. Now throw in the risk of complications associated with colonoscopy and you'll have a whole new perspective.
Any positive Cologuard test is FAR better than a false negative colonoscopy or a complication.
@@carlpahnke8992 you must work for Phizer as a salesman ....no thanks
@@Former_Pastor nope, I did however know a gal that was killed by a botched colonoscopy. That'll never happen with cologuard
"Many can get a colonoscopy at no charge if they're over 45" - yeah would be nice for those of us who have a family history and increased risk of getting colon cancer earlier than that. God forbid I have a reasonable concern that I could have colon polyps or even tumors at 30. Especially considering that the age of people with colon cancer is trending downward at an alarming rate.
Health care in the country is a joke.
This is not true. The incidence rate of colorectal cancer in age groups below 30 remains at less than 4 in 100,000 population. Once you reach age 45 the rate rises to over 30. That is why screening is free for those 45 or over. Health insurance companies do cover screening for people under 45 with high risk due to family history.
@@meinempanadas I've read several studies that conclude that there is a 7.5% increase in incidence of colorectal cancer in the 20-29 age group. We don't know why this is happening, but the trend was observed between 2004 and 2016. What's more is that it could be even higher than that, as it's been about 5 years since the last data was collected for this particular study.
And, no, my insurance provider was well aware that both of my parents died of cancer, one of which died of colorectal cancer. They still refused to cover a colonoscopy, despite me having clear symptoms of colon cancer. Thankfully, I only had benign polyps, but the risk was still there that they could have developed into cancer before I turned 45. It's unpredictable, but the oncologist said that some of them were large enough to be concerned about developing into malignant tumors, and it was a good idea to get screened when I did so that they could be removed before that happened.
Here's a link to the abstract of that study, by the way:
gut.bmj.com/content/68/10/1820
This study was done in Europe, in interest of full disclosure, so fair enough it could be some kind of exclusively European phenomenon. I swear I found one for the US that had similar findings, but I was unable to retrieve it. So, I might have been confusing a different study for something else with a second American version of this study.
@@danieltaylor4185 Studies outside the US are not relevant to US health care. The World Cancer Fund doesn't even list the US in the top 20 countries for colorectal cancer. The numbers in the US have steadily decreased, not increased.
@@danieltaylor4185 Yup this is true. I know someone who both parents died to lung cancer, but they said she can’t get screened until she’s 50. Both parents died in late 30s to lung cancer. That’s the joke of USA healthcare industry.
@C C Yeah, wish I could. Our "representatives" don't seem to care enough to put in a real health care system so I guess we get to suffer until the previous generation of politicians die of old age and we can finally get something done for once.
In insurance company talk, you're getting two colonoscopies, one after another, so the second one (the real colonoscopy) is looked at as unnecessary. To avoid any issues and fighting, just do the regular colonoscopy and forget about Cologuard. Everyone hates prepping for it, but if it ends up avoiding thousands of dollars in bills, just go that route.
^^^This is the moral of the story.
Over 80% of the users of Cologuard are negative and able to skip an invasive procedure that doe's come with a risk of complications. Not only that but colonoscopy does not always find cancer and polyps that are there.
@@carlpahnke8992 I would say go with the colon guard if you refuse to do the colonoscopy but I don’t see why not also do the colon guard if you don’t have any symptoms or no family history.
A colonoscopy after a positive test whether it be Cologuard, or a FIT test is not looked at as unnecessary, it is now looked at as a diagnostic test instead of a screening, and insurance companies will typically fully cover a screening colonoscopy, they will not fully cover a diagnostic colonoscopy.
@@carlpahnke8992 Cologuard only detects 42% of large polyps, and it can't remove them as is done during a colonoscopy. After I had 2 positive FIT tests followed by a completely negative colonoscopy, no polyps, nothing, I'm not sure how I feel about these alternative tests.
Health care is a mess in America! It’s no joke!
Most Americans have been able to get flu shots, Covid Vaccine and other things for little or no money. Most insurance companies are pretty reasonable and you do get a tax break when you take for this care.
@@robertagabor3736 .
Per capita a US citizen pays about twice that paid by a person in the UK.
For that extra, they get healthcare that doesn't cover everybody and ranks lower in world rankings for quality of care.
Everyone is getting raked over by their insurance company.
Not only insurance but Doctors Hospitals and everyone else associated with the health care system.
You are actually being raked over by the Government. Get government out of health care watch it become affordable again. Health care is not better today.
This should make us all mad-what a mess the US healthcare system is.
Yep, and to think 50% of us voted for someone who wanted to do away with Obama's plan.
I just had one a few days ago. I paid 0$. 0€ in fact since i live in the EU. US healthcare is a scam
The American “healthcare” system is a shitshow…period. I don’t have health insurance. It’s pointless
Ms. Christy, you are taking a huge risk. I am healthy, but took a fall that landed me in an emergency room one night. So glad I had medical insurance or I would have had to delay my early retirement!
Be careful Christy :/ I also didn’t have insurance but then I got it and I had to replace my crowns so I saved me a few thousands but good luck!
Insurance is like going to a casino, lots of money out and very little back, if you're lucky.
My husband is 45 and his doctor wants him to have a colonoscopy for screening. However, after calling the insurance company I now have learned that he would have to pay out of pocket because they don't cover until 50. This is sad and ridiculous.
Welcome the the earth's worst healthcare in history
Ask your dr to request procedure from the insurance company. Your dr can explain special circamstances and hopefully get an approval.
That is crazy, especially given the steady rise in colon cancer in people under 50.
@@AC-ro6ib that is because of your western diet of processed meats, plants and junk food.. what did you expect to happen?
Just eat your natural diet of Fresh NON processed meat and you would not have this problem...
also on a meat based diet you would not be pooping massive leavings every day
Absolutely. Our healthcare system is evil but the way we eat causes a lot of our health problems. But I’ve learned people would rather take their chances with their health by eating any and everything and then blame the healthcare system when they profit from those choices. Eat more vegetables than meat.
Cologard has false positives so just get a full colonoscopy!
The colonoscopy is covered , then you get billed for biopsies. The biopsies are not covered ,cost as much as the colonoscopy, and that cost comes from your wallet. The biopsies are overpriced. I paid over $700 for 2 biopsies.
Just because Medicare says it’s covered ,it does not , you get alacarte charges.
Well if the test is negative then you don't need the colonoscopy.
@@shirleyhobbs2081 you could appeal that. It was part of your covered preventive care.
@@alexandrajackson8498 I did appeal x5 , paid it because it was going to ruin my credit rating.
ColoGuard is 92% accurate, an invasive colonoscopy is less than 50% accurate & cannot detect cancer until polyps are growing. At that point cancer has advanced. Someone has sold you a bill of bad goods. Stay well.
For as long as healthcare industry is traded on Wall Street never expect good healthcare because that erodes their value and shareholders get upset
So when will you be opening up a hospital / clinic? If so many people don't like the current system, you should have an unlimited market no?
@@bobroberts2371 Ah, how naive. "Health" care was locked down in the 1940's. That's why you're thrown in jail for practicing without a license. How do you get a license? You maintain good standing with the medical board in your region. Which is controlled by the broader medical industrial complex.... which wants you doing things their way... See Morris Fishbein and AMA in 1920's. Rockefeller medicine as well.
Healthcare in general, cancer specifically is a racket.
YEP,,total BS!!!
Why do you think they don't want to cure it!!
Any time you see an ad on TV for something, it's not because they care about you. They are just trying to make a profit
I red flag companies that advertise constantly bec nobody should be on a perpetual quest for customers. Something is def wrong there.
@@msr1116 exactly. I decided not to take the test and the company is constantly ringing my phone even after I requested they stop the phone calls. They're like annoying vultures ⚠️
That is not true. While a profit is necessary to stay in business. Many medical therapies are from companies founded by well meaning researchers hoping to save lives.
@Former_Pastor Did they?
The exact same thing happened to me over, $1400 out of pocket. Next time I will go straight to the colonoscopy no Cologuard for me ever again.
Lesson learned. Call it a day and stop whining.
@@meinempanadas nope we need more whining so things change. Go back to your old man cave.
You dont seem to understand that had you gone straight for a "screening" colonoscopy in the first place, as soon as the GI doc finds a polyp, it becomes a DIAGNOSTIC PROCEDURE and your insurance company bills you for the procedure. Screening tests like Cologuard are FREE under the ACA Healthcare Mandate. Diagnostic tests are NOT!
I think the cost of the kit is about $500.00 and that is it.
It’s not whining it’s warning people to look into this before they get the cologuard. Most people end up with a colonoscopy after the screening. Why waste the time, just get the colonoscopy. It may not cost as much if it is coded correctly. I was specifically told by insurance (Anthem) if I had not been screened with the cologuard ,I would not have had to meet my deductible plus some . They said the colonoscopy would have been a free screening.
Under the “Affordable Care Act”, yeah if that isn’t a misnomer I don’t know what is.
It’s better than what millions had before that, which was zero coverage.
Don’t like the current policies? Work to get rid of progress-blocking legislators. Here’s a tip: they are overwhelmingly Republicans.
@Philip M Exactly!
Before the Affordable Care Act colonscopies were not free like they are today. They just aren't free if you precede the colonoscopy with a useless cologuard test. Just get the colonscopy.
Cologaurd isn't the problem it insurance companies that are the problem
👏🏽👏🏽👏🏽👏🏽💯
@K Bleeker
Swing and a miss.
a simple test kit made from plastic costs $700
Gee thanks! For making us aware of what’s happening with this colon test. Really appreciate it 👍🏼
Just for the record If you have a preventive colonoscopy and it finds anything you are charged because it was no longer preventive. So while you have the test thinking it covered as a preventive procedure you can wake up to a nasty bill.
I know it's a popular term but "preventive" isn't correct for any diagnostic procedure--you either have the condition or you don't. Having the procedure won't prevent you from contracting something later--it'll just (hopefully) detect it early if you do have it.
Correct. This happened with my husband’s colonoscopy. Insurance companies will do anything they can to reduce the amount they have to pay out, it’s really maddening!
Incorrect!! I had a polyp removed and tested. There wasn't an extra charge because it was found during a preventative procedure. Also the patient can go on their insurance carrier's website. Go to provider information. Medical policy bulletins and pull up the procedure. Ask your doctor's office for the CPT (procedure) codes, diagnosis codes and modifiers to see how everything is covered. You'll also see the codes that are to be used and you can pass them onto your doctor.
@@alexandrajackson8498 it must depend on your insurance. We tried to see if there was a different CPT code and they would not change it.
You have no clue what you are talking about.
I have a ColoGuard test kit in the closet. I will be sending it back. Thank you this info!
I've taken two Cologuard tests and am due for my 3rd. It's super convenient and is 94% sensitive to detecting early stage cancer in Stage 1 and Stage 2. It totally outperforms the $25 cheapie FIT test that does nothing but detect if you have blood in stool. And Cologuard is covered by the ACA mandate. I have Blue Shield of California and have never had to pay for the test. It's Free, with no co-pay per the ACA mandate and being included in the U.S. Preventative Services Task Force Colon Cancer Guidelines.
I had cologuard test cost me $649.00 out of my pocket. I had Blue cross and Blue shield @ the time. Even filed an appeal. Still BCBS refuses to pay.
They are good tests. The chemicals introduced into the specimen help to identify any pathology.
Cologuard detected my colon cancer. I had no symptoms. Years of doing the FIT test didn’t catch it because FIT detects only for blood, which I had none. Insurance companies don’t want to pay for anything. Your health is worth paying yourself. If nothing is found you have gained peace of mind.
@@leslieclaire Agree w/you ! I’m not being negative about cologuard @ all. I would rather do cologuard than to have to go thru the full colonoscopy procedure. Plus if insurance companies would pay for cologuard the insurance companies would come out ahead in my opinion. Save money and plus more ppl would probably get screened for colon cancer. Ty for your reply.
My doctor wanted me to do this and a box was sent to me months ago. I just cant bring myself to use it. Seeing this makes me glad I didn't.
Ditto!
Do they still charge you if you just keep the box and not do the test?
@@4403323 nope I eventually threw it away and I only got a few reminders about doing it and that eventually stopped.
@@SchardtCinematic thank you, that's good to know. I let a Dr. talk me into having a Cologuard test sent to me. After seeing this story I have no intention of using it.
You are stupid not doing the test.
I got a positive stool test. My HMO charged me $1000 colonscopy because it was considered diagnostic surgery.
I was eligible to get the same colonscopy for free as a preventive measure. The colonscopy was negative.
I found out the day of the colonscopy that instead of the expected $10 copay they wanted $1000.
Hey that’s despicable of them frankly. You shouldn’t have to pay $1000!
Even in this piece, they say that SCREENING for colon cancer should be covered by insurance. Let's go further and say that TREATMENT should also be covered.
I had a false positive with Cologuard. My physician said that 65% of the results of this test is either a false positive or a false negative. He said I should have never had it prescribed by my PCP.
This is WHY tv ads for RX needs to be banned
Especially when they try to diagnose stuff over the air.
Kevin Conroy basically said thanks for letting us know our legal writing needs some work and we will put all this in the fine print for next time.
Yep. Happened to me. Doctor never explained this could be the outcome of a positive test. Ridiculous! I had the colonoscopy, but the cost was high and I should not have been charged. This should be clear when deciding whether to use the test or just getting a colonoscopy.
Same
Frankly, my own personal experience with the Cologuard test left me with two observations.
1. The test is so sensitive that it produces a significant number of false positive results.
2. A traditional colonoscopy isn't nearly as bothersome as I thought it would be.
Going forward, I'll just skip to the colonoscopy and avoid the 10 days of worry over the positive Cologuard result.
A test's sensitivity has nothing to do with false positives. If anything because it is so sensitive you will get less false negative results because it is so good at picking up pathology
With a colonoscopy if they find no polyps, it's ten years until your next one. I just very recently had my second colonoscopy, and again no polyps, so once again I don't have to worry about another colonoscopy for 10 years. The Cologuard test has to be taken every 3 years after a negative test, and if you do test positive, you'll be getting a colonoscopy, and you'll be paying for a diagnostic colonoscopy that is not fully paid for by insurance as a screening colonoscopy is. Might as well just get a colonoscopy in the first place.
But is Cologuard the same as previous stool tests? The ones with were you only had to send the scoop?
@@bbygrlpt2 Pretty much. What the exact lab procedures may be, I couldn't say. But, I would imagine that they have evolved over time.
@GrumpyBoomer You are correct. I just got a positive result with Cologuard and I am extremely worry now. I don’t have any of the symptoms mentioned in the pamphlet so I am freaking out more now. I am working on scheduling a colonoscopy now. Were your colonoscopy results the same as Cologuard?
It’s sad how things are getting, a relative had those sent to him by his PCP, he never took that home test, thank God, the mere fact that the insurance company wouldn’t want to pay if you get a positive reading and the bills are on you was something i never thought about after seeing those commercials!
The solution: don’t let the insurance or doctor know you took an at home test
Also it would have been interesting to know what the colonoscopy came back with vs the home test
But then the same idiots would whine they had to pay for the at-home test.
The Cologuard test is a prescription that your doctor has to write and the insurance company knows you filled once they have to pay for it.
Your doctor has to order it
You CAN'T take the test without a doctor ordering it.
Who pays for it, if you're not paying for it?
The solution: Don't use Cologuard. They're crooks. Probably at least most of the tests come out with false positives.
This goes for any at home tests sent to you from Home Access Health Care (now known as PWN and owned by Everlywell) this place is awful and has had multiple PHI breaches they just sweep under the rug. -Sincerely, a former employee
That isn't Cologuard.
@@robertagabor3736 Didn’t say it was. Just saying that kits from this company are just as sketchy and it’s basically the same as Cologuard. Cologuard is one of their biggest competitors.
Colonoscopy is not free. The Anesthesia bill is separate and if you don't have insurance you have to pay for the procedure unless you have medical or some other form of insurance. Still hoping and praying for an easier, less complicated screening test and more accessible to all people.
Yeah that won’t happen.
I went for a screening. I got billed because the doctor found two noncancerous polyps and removed them. Insurance said the doctor did not bill my test as a preventative screening. I got scammed but I had to do the "screening". I guess it's a preventative screening ONLY if the doctor finds nothing wrong.
It could be the doctor just needed to resubmit the bill to the insurance company with the correct code.
This happened to me just yesterday! Several MONTHS ago I did the cologuard test, which came back NEG. Yesterday I got a bill for $695. I will be calling my insurance company and disputing this charge.
Did you?
@@SamanthaSweetAnne yes I did and got it removed but it was super annoying!
CEO just basically told reported that doing the bare minimum is OK because going over and beyond to inform customers that if they get a positive test and a colonoscopy is required there will be out of pocket cost because most insurance won’t cover it because it will be billed as out of network. if they were to pull all the old commercial or edit the old commercial to inform customers about the potential of them getting a positive results from the at home test and requirements for the colonoscopy test they will lose customers and in turn bottom line.
The problem isnt with Cologuard. And it has nothing to do with being "out-of-network". Any "at-home" colon cancer test is Free with no co-pay per the ACA mandate as one of the 10 Essential Healthcare Benefits, under Preventive Services. Cologuard is Free. The cheapie Fecal Immunochemical Test (FIT) is Free. (But it does nothing other than detect whether or not you have blood in your stool). - - - As soon as a "screening" colonoscopy detects a polyp, it becomes a "diagnostic" colonoscopy and your insurance company will bill you for the procedure.
Romario Hylton Are you saying the CG should be responsible for researching every insurance co / patient situation that exists ? They don't provide ins nor should they be held responsible for what an ins co does.
@@bobroberts2371 At the very moment yes. This present moment they know now that if a customer purchased a product and they get a positive result the customer would have to go to a doctor and get a colonoscopy. Upon getting the colonoscopy they will be billed as out of network and they would incur out-of-pocket cost. The reporter asked the CEO if it would be better for the company to remove the old commercial and air a new commercial with the new information that the company now have on customers who gets a positive result. He said now because Hearing new commercials with the new information would make customer not purchase the colon test kit.
@@romariohylton3963 So will you hold the makers of any medical test to the same standards as you want CG to be held to? If so, expect costs to spiral out of control as whole office blocks of researchers and lawyers would need to vet every possible situation.
I used this test and received a bill for over $700. I called my insurance company and they said the company that sent the Cologuard test never submitted the charge to them. My insurance company paid the full bill.
Hmmm, is it the test at fault? A more accurate title for the segment would be "Insurance Companies are Still Shady, Reason no. 37,839"
This same thing happened to me. I got a false positive and then a follow-up colonoscopy. Then I got a bill for several thousand dollars.
Same thing happens if you get a questionable result on a screening mammogram and they call you back for repeat imaging. The initial imaging is considered preventive and therefore is fully covered by many insurance plans. The second procedure is being done to diagnose a potential problem found during the first procedure, and therefore is no longer considered preventive, so it is covered differently by insurance. This is just how insurance works and something people need to understand. Just get a screening colonoscopy, folks. The procedure is not bad at all.
And they wander why we don’t care about the healthcare ceo
Welcome to the American healthcare system
Welcome to American capitalism - rich swindling poor, infirm, vulnerable. Uncivilized society
You are clueless.
I am a colon cancer survivor, and I had really crazy experience about how American insurance companies "treat" the patients. Just 7 days after the intestine removal surgery, I was still weak, with the the stitches still in my stomach and the body bloomed like a mushroom because of continuous potassium IV in the arm, suddenly the insurance company cut the coverage, saying that once the hospital's meal type changed from the liquid to the normal, they couldn't provide any more coverage. Doctor told me that I could stay at they hospital if I would like, but without any insurance coverage, the "room charge would be $4,000 per night"!!!!!
What an insane standard the insurance company sets up, just to keep profits from the patients???
I truly believe that's why Chadwick Boseman continued to work so hard while sick, he had to pay his medical bills. Both of my sons have crohn's disease and have had several hospital stays, colonoscopies, labs, and tried just about all the medications out to treat it. My oldest had an ileostomy for 6 months. Thank God we have medicaid. The only times I saw prices were when I received the medications. A single Stelara or Humaria dose is $24k. You can't afford to be sick. It's a blessing that you survived.
That is nuts. My mom died of a rare form of colon cancer even though she had a negative colonoscopy 2 years before . It couldn’t be detected because it formed a thin sheet of tumor in the lining of the intestine
Who is your insurer?
@@gloriamontgomery6900 yes in that the initial tumor couldn't be detected, because the initial symptom was not from the tumor. Tumor was developed from a small polyp. In my case, typical symptom emerged first, unexpected pain in the stomach, which was not common pain but very "foreign" fatal pain, to the point that you would lose consciousness. In my case, tow polyps have already developed inside the intestine cells, which become tumors...doctor discovered them when I visited my doctor for the completely different matters, a severe burnt on my leg. But he immediately noticed that something was wrong because of a big loss of weight (due to blood losses).. More than 10 pounds lost in 10 months before the doctor noticed.
@@Mita7538 At that tine, is think it was Aetna. It felt crazy when they insurance company abruptly cut the coverage just because the hospital meal was changed from semi-liquid to the normal, from yogurt or jelly to a chunk of chicken meat! even when my stomach couldn't digest a meat!
IT IS TIME FOR UNIVERSAL HEALTH CARE and DUMP the GREEDY for PROFIT INSURANCE COMPANIES
No, it is time for universal end of stupidity.
Garnet Rose and how do you plan to pay for that?
@@adamschroeder693 the same way we have been paying for all the wars, regime change thanks to democracy.
Democracy through the constitutional process has produced Presidents: GW Bush, Barry Soweto Obama (who helped create this confusion in 2010), Donald Trump and the very confused pair we have today.
If this is the best we can do in the last 20 years, then democracy is not working.
We're not the only country with some doozie old folks, Vlad Putin and younger blackface wearing theater majors to the north.
@@STho205 #TRUMPLOST #EIGHTMILLIONVOTES #GETOVERIT
I was warned by my insurance agent when I turned 65, they won’t cover the cost of both. One is a preliminary test (positive or negative) , a colonoscopy actually looks to determine true or false.
Good ol USA. We don’t care if your dying or want to get checked for something, gonna pay an arm and a leg.
Some countries health insurance has most bills covered - no copays or deductibles.
Because I'm on a blood thinner, I couldn't get a colonoscopy so my dr. went with the cologuard. When that came back positive (the test has way too often given false positives), I ended up getting a CAT scan instead of the colonoscopy. My insurance covered that with just the small fixed co-pay.
CAT scans don't work the same way, but it's better than nothing. Probably over 90% of those "tests" come back positive.
@@robinlillian9471 My CAT scan was with contrast, and inflating my colon with air. VERY UNCOMFORTABLE during test!
this is no longer true....Starting in 2023, Medicare, Affordable Care Act, and commercial plans will now cover, as part of preventive care and screening, a follow-up colonoscopy after a non-invasive stool-based test returns a positive or abnormal result for patients 45 years of age and older.
Thank you.
Universal health care, this THE way!
"Just poop in a box and mail it to us!"
How could you ever suspect a company like that wasn't doing everything right?!
I always thought that was kind weird myself, what person would send a stool sample through mail?😐, but that still doesn't beat having kids receiving a 'Pet rock' toy through mail.😒
@@b75s The Fecal Immunochemical Test (FIT) that detects blood in stool is sent through the mail too.
Cologuard is FREE per the ACA mandate of being a Preventative Service under one of the 10 Essential Healthcare Benefits. It is a "screening" test for colon cancer and is free with no co-pay. As with any other screening test, if one must have a follow up "diagnostic" procedure (such as colonoscopy), then their insurance company will bill them for that. You dont seem to understand the difference between a "screening" test and a "diagnostic" test. The former is FREE per the ACA mandate. The latter is a billable charge by insurance companies.
Just a note if you get a test from a company known as Home Access Health (now known as PWN and owned by Everlywell) throw it out. The company is a joke and very careless with your health info-sincerely a former employee
@@theman7095 The former is a scam, while the latter is not.
I tried this Cologuard and received a bill for $69.00 and test was negative. My insurance is Harvard Pilgrim.
But the talking box seemed so trustworthy!!!
That's horrible. My doctor at my yearly exam required me to get this thing. Mine went negative, but to know that if it was positive I'd be charged 1900$.... I'm sure my primary care physician didn't know that; she would have told me.
Shipping crap through the mail is disgusting anyway. What if they get some on the outside, or it busts open? People ship food through the mail!
Eating mailed food is gross too.
It is well contained and in a chemical solution. So marked as "fragile" or otherwise so that it is handled carefully.
What if I told you... poop is funny.
The specimens are sent via FedEx 2-day Air in specialty clinical packaging. There are regulations that must be met to ship any biological substance. Shouldn’t be any risk of leakage if you know how to properly secure a lid.
@@mindfullymellow2323 old people mail these things! Properly securing anything is a challenge , for them...
Why are we still the only country that has pharmaceutical information as ads? Europe doesn’t do this, If you have an issue see a doctor!
Let's not forget that all this misery with medical insurance and high costs,are the result of Americans voting republican.
Oh wow! That’s so ridiculous! Poor lady! I ,thank goodness, had a negative test but I still get grief from drs to get a colonoscopy and there’s nothing wrong with me!
My doctor said these test kits are basically a waste of time other than they help get people in for colonoscopies who might not otherwise. Some people put the procedure off for various reasons including fear , after having it done I can say it was no big deal , the preparation at home was the worst part , cleansing your system out.
You can make it easier by just eating only jello and broth for the 24 period preceding the prep. Really.
@@kayfarquar2034 Thanks for the tip.
We live on social security and a very small pension. We have Medicare and Tricare and we are totally covered but I really feel sorry for people younger than we are, because medical costs are outrageous.
This is great information. I was about to order a cologuard kit but now I am going to check with my insurance company regarding a follow-up colonoscopy and how they will handle the claim. Great job reporting this.
Everybody between 55 and 75 is screened for colon cancer is by the government in the Netherlands.
Of course the follow up is paid by the assurance company.
Its much cheaper to treat people in the early state than later.
Technically it ‘catches all colon cancers’ if it gives back a positive result all the time, regardless of whether it’s actually positive or negative. It just includes all of the false positives along with it 😂😂😂
the accuracy rate is low 90%
Are false negatives common?
Yeah we’d rather have false negatives than false positives :) a little offering to the gods
@@michaelk7194 OK Doctor what is more important, the sensitivity or specificity of a screening test? What percentage rates of each is acceptable when screening for cancer and why? Consider how many patients YOU see that flat out refuse lower endoscopy and the poor specificity of Hemoccult tests.
I got a bill for $665 my insurance was supposed to be 100% coverage. Had to fight the costs
I’m some countries it’s given for free, USA where it cares more about money than it’s citizens
USA citizens need to be their own best friends when it comes to personal health.
@@joedellaselva1251 That's hard when they prevent placental transfusion by clamping off your umbilical cord immedaitely after delivery, then pump you full of vaccines and bad food long before you ever had a chance.
Not free when taxes are sky high.
My doctor told me that they prefer/insist to do a full colonoscopy for the first test in a person's life. After a negative test there, the screening test can be used.
In my 60’s now, I’m not doing anymore tests. 30 years of yearlies, that’s enough!
Im 55, ain't had a test for anything yet. Mom is 82, ain't had a test for anything yet.
Yeah, my grandma lived to 100, she was too busy on the farm….
You never know how good your health insurance is until you file a claim. The fine print system is used by all of them.
This doesn't happen in countries with socialized medicine.
Yep. There system is far superior. But the GOP only cares about corporate profits, not people.
So if my insurance covers one colon test why use that up on cologuard in the first place ?
He knew!! Just do the covered PREVENTIVE colonoscopy that your insurance pays for. Cologuard isn't for HIGH RISK patient. Know your family health history.
As soon as a Gastroenterologist finds a polyp during colonoscopy, it becomes a "diagnostic" test and the patient is billed. The problem with most people (and the woman in this video) is that she wasnt educated about how there is a difference between a "screening" test which is covered by the ACA Mandate to be free with no co-pay vs a "diagnostic" test. She would have been billed for the "diagnostic" colonoscopy regardless of what "at-home" test she took, whether it was the Cologuard test that is 94% sensitive to detecting colon cancer in Stage 1 and Stage 2, or the cheapie $25 FIT test (that Kaiser Health hands out) and does nothing but detect blood in stool.
I had a similar experience with my mammogram. I had requested my annual when I had some tenderness. I called my Dr. She checked and didn't find anything but changed my yearly preventative to diagnostic costing me over $600. Insurance is a shell game.
Shouldn't have mentioned tenderness to the doctor. Oh well, it's already charged!
Imagine what a single payer system and actual capitalistic competition would do for the healthcare industry… Tired of the criminal cronyism. Mandatory insurance should be illegal
Without insurance, you really do have no protection. Get sick, lose your home because you can't pay, and start living on the street. Sure, that's a MUCH better deal. Hospitals charge people more when they don't have insurance, too. "Mandatory insurance" means no one has to pay big bucks for medical treatments, because everyone is covered by the government. Medicare is the cheapest insurance out there. The problem is that it only pays 80%, and even the 20% can bankrupt you.
I used it, works great! My insurance covered all the cost! So thankful!
Which insurance?
I recently had a dental procedure that was covered by my insurance, but my dentist had to appeal the claim decision and prove that the procedure was necessary…all because the bill was high & my for-profit insurance didn’t want to pay. In the end, insurance paid as it should have since I had a covered procedure. I’ve never experienced this before & it really opened my eyes to how evil & greedy insurance companies can be.☹️
Maybe we should just pay for the cologuard out of pocket. How much does it cost?
Private insurance rakes everyone over the coals at some point or another. M4A!
Thank you CBS Mornings for helping to protect consumers.
She is getting raked over. Which is the name of their game!!!
No, she is being billed as per her coverage. It's that simple.
Nope. She doesnt seem to be very informed. All "screening" tests are FREE with no co-pay per the ACA Mandate. But a colonoscopy becomes a DIAGNOSTIC TEST as soon as the GI doctor finds a polyp and the patient gets billed for the procedure.
@@theman7095 Or as soon as the screening test gives a false positive and the colonoscopy says nothing's wrong.
What is needed is similar to the mortgage law: a Good Faith Estimate of Costs for all medical bills.
I’m just gonna go with good ol relax and breathe.
The doctors should not have an option as to how they code the billing. It's should default to whatever is best for the customer.
The problem with colonoscopies is you need a relative or friend to drive you home or to an area hotel after the procedure. Only screening of it's kind that is like that. They wouldn't let me take a taxi for instance unless I could prove I knew the taxi driver personally. Cologuard takes the travel and the nonsense out of the equation. I saved about $300 in hotel expenses alone. Us singles like the home remedy a lot better!
I've got the exact same issue, no one to drive me home afterward. So if I get a positive Cologuard test I'm stuck with knowing I MAY have colon cancer & can't do a thing about it. No thanks. Sometimes ignorance really is bliss.
Yea, but 45% of Cologuard test results are a false positive! Just find some to drive you home.....boss, work mate, neighbor, anyone.
You aren’t saving anything. Besides you can take a Lyft.
I still have my box sitting here. Glad I saw this now
Did you ever use it?
@@SamanthaSweetAnne no
My doc says cologuard has too many false positives. He's right, mine was false positive. Just have the colonoscopy cause you'll end up there anyway.
Such a horrible situation with health insurance in the United States. Really stinks that life saving and life enhancing treatments and medication is dependent on a broken system.
The problem with a for-profit medical insurance system is that the way for-profit insurance companies make money is by avoiding paying out claims, whether for auto, home or business insurance. If people don't like this then they need to support universal healthcare and vote for Bernie Sanders.
The 2020 election is over. Even the Left doesn't seem to get that. Bernie Sanders is a doll, but he's old--and if he even runs & wins (doubtful against a Biden incumbency) in 2024 all his left wing, authoritarian followers will win, too. They're just as bad as Trump's cult or worse. MAYBE, they will vote in universal healthcare, but most likely they will refuse it to anyone who eats meat (probably that will be illegal), smokes, drinks soda, is overweight, or has any bad health habits. Results: probably very few would actually be covered. Oh, yes, and they want to eliminate your right to vote if you are a Republican, and put you in a concentration camp if you didn't get vaccinated (probably even if you have a health problem preventing it). So much for freedom and democracy--or common decency. I voted for Bernie the first time, but I wouldn't do it again, mostly because of how hateful & evil his "followers" are.
All of this and nothing. they didn't even say if she had any problems with her colonoscopy results.
Nationalize Healthcare like Canada, Japan, Singapore, or France...
The only people I would know that would do this is ones that do not have insurance.
Only in America!
Right, so people aren’t checking their coverage beforehand and getting angry when they find out it’s not covered, but that’s the manufacturers fault?…
Yep and these are the same people who go all around the Internet telling other people and politicians how to live their lives and do their jobs. Call your provider before to get all the codes associated with any procedure you might need. Call your insurance company for an estimate of your out-of-pocket cost. Now you have a better idea of how you should move forward. No surprises if you do your research.