Colon cancer is the third-leading cause of cancer death, but it is almost entirely preventable by scheduling routine colonoscopies. Unfortunately, millions of eligible Americans are still not getting screened for colon cancer because of cost. The Affordable Care Act (ACA) has helped address low screening rates for colon cancer and other diseases by eliminating cost-sharing for Medicare patients.
Under the ACA, private health insurance companies and Medicare are now required to cover recommended preventative screenings such as colonoscopies without any cost-sharing for patients. Initially, patients were responsible for anesthesia costs, but the Centers for Medicare and Medicaid Services (CMS) released a preventative and screening services update in 2015 to include anesthesia in its definition of “colorectal cancer screening tests.” This means that most screening colonoscopies are covered, and patients do not have to worry about out-of-pocket medical expenses.
These same benefits do not extend to diagnostic colonoscopies (when symptoms are present), and the fear of high medical bills deters many patients from getting the treatment they need. Even when having a screening colonoscopy, beneficiaries could be subject to cost-sharing if polyps are found and removed or if tissue is biopsied during the procedure.
The best way to prevent colon cancer is through screening, and the only way to increase screening rates is through education. People who are at average risk for colon cancer should get a baseline colonoscopy at the age of 50, or 45 if they are African American. Family history can also lower your colonoscopy screening age. If you have a first degree relative who had colon cancer, you should be screened ten years before the age your relative was at diagnosis (Source: NCCRT).
Colonoscopies save lives, one procedure at a time. If everyone gets screened at the appropriate time and in the recommended intervals, most colonoscopies will remain screening colonoscopies and will not be subject to cost-sharing. Talk to your doctor about when you should be screened for colon cancer. Preventative screening is the key to good health and staying colon cancer-free!
