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How Cologuard Tests May End Up Costing You Thousands

A Missouri woman wound up with a $2000 bill because of an at-home colon cancer test.

Lianne Bryant used an at-home colon cancer screening test called Cologuard. The test came back positive. This meant she needed to have a colonoscopy – and was stuck with the bill.

Bryant decided to use the test after seeing TV commercials. She thought it would be easy and even called her insurance company ahead of time to find out if they cover it. She was surprised when her Cologuard test came back positive and was worried she might have cancer. Any time a Cologuard test is positive, a colonoscopy should be performed as a follow-up.

Fortunately, Bryant’s colonoscopy was negative for cancer. Unfortunately, her colonoscopy wasn’t covered by insurance because she had already used her screening coverage for the Cologuard test.

The Affordable Care Act requires insurance companies to cover routine screening for colorectal cancer. However, most policies don’t cover a Cologuard test and a colonoscopy. That was the case with Bryant’s insurance company. Contacting your insurance company directly is the best way to find out.

Bryant was able to successfully appeal the claim and the insurance company ultimately covered the cost of her procedure. This process took many calls over 5 months. It worked out for Bryant, but others have not been that lucky. It all depends on the insurance plan and the individual situation.

Cologuard tests, while convenient, often have false positives. A false-positive test is when the result says you may have large polyps or cancer when you really don’t. The only way to know for sure if the result is real (meaning you have a polyp or cancer that needs treatment) is to get a colonoscopy. Nearly 66% of positive Cologuard tests are false positives.

If you are considering whether or not a Cologuard test is right for you, schedule an appointment with a gastroenterologist to discuss. Any colon cancer screening is better than no screening, but patients should know the pros and cons before making a final decision.

To be clear: Cologuard is not recommended by GCSA physicians as a replacement for a colonoscopy.

Don’t delay your colon cancer screening – schedule your appointment today!

Read More: The Truth About Cologuard Tests

Source: CBS News

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