Insurance assistance - new Forum?

We already have a lot of forums, so it probably will not happen.

Also, there are so many variables. Different health plans and health plan companies. Different providers. Different states. The ACA regulations are nationwide, and the “no cost” colonoscopy is part of the ACA. However, to be “no cost” it has to be a routine screening colonoscopy. Once you have symptoms and/or a diagnosis, it is for diagnosis or follow up/maintenance. If you have a j-pouch, you ovbiously have a prior related diagnosis. Of course, this may all change if the ACA is repealed.

I think you were just lucky to convince your providers to code your scope to be covered under the ACA. Both my husband and son have UC (and their colons) and so not qualify for “no cost” colonoscopies and their procedures are subject to their deductibles. My brother had a bleeding hemorrhoid (symptoms) so his colonoscopy was diagnostic, not routine screening.

I was able to successfully petition my health plan (through the grievance procedure) to charge my scope as a flex sig without sedation, when it was incorrectly coded as a colonoscopy, by mistake. 

The point is that there are a number of things to take into account. I do agree that healthcare is still too expensive, and the premium assistance is not offered to enough people. The middle class is screwed. It will get worse with the removal of the individual mandate and more healthy individuals drop their coverage.

Jan