Hello all,
I finally have my colonoscopy scheduled for the end of the month. However, while checking things out with the insurance, hospital, lab, procedure fee and anethesia, it looks like it will cost anywhere from $5700 up to $9575, mainly due to the hospital facility fee. They gave me a range of $4,300 to $8000 just for the 3 hrs I would be there.
My Dr's endoscopy clinic charges an $870 facility fee for the same time spent. Unfortunately, since I've lost so much weight, I now fall into a pediatric category and they can't perform the procedure at their clinic since I'm under 85 lbs.
With the costs so high, and they don't offer any payment plan, I cannot see how I can afford to have the test. The Dr. is checking around for me to see if there are any alternatives, but it looks like slim pickings.
Does anyone out there know about financial assistance for such a situation? We are kind of stuck in that we have very little income, yet have our house as a good sized asset, but its been on the market for 1 1/2 yrs and no bites, so I don't know where we are, since we really don't have any money. The house is already all mortgaged up.
Any ideas or suggested resources would really be of help. I feel I really need to have the procedure done since we still don't have a definitive diagnosis, but this is just too much to handle.
Thanks,
Robin
Costs of colonoscopy
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Hi Robin,
Your situation is not all that unusual, and conventional practices can make life pretty tough for those of us in that situation. There are a few programs available that you might be able to take advantage of. For example, if you happen to live in either King or Clallam county, and your doctor is willing to classify your need for a colonoscopy as a test to rule out possible cancer, (which is certainly not unreasonable, since colon cancer is a primary cause of diarrhea), thanks to a three-year federal grant, community clinics in those two counties can refer patients to gastroenterologists for free colonoscopies. The program, however, is available only in King and Clallam counties. Patients must be uninsured and have incomes below 250 percent of the federal poverty level, or $26,000 for a single person and $53,000 for a family of four.
http://seattletimes.nwsource.com/html/h ... er31m.html
If you can't qualify for that program, then the second-best option would probably be to opt for a flexible sigmoidoscopy, rather than a colonoscopy. A sigmoidscopy does not require sedation, and can be performed in a doctor's office in 20 minutes or less. Even if done in a hospital, the cost of a sigmoidoscopy should be significantly less than the cost of a colonoscopy. If your doctor sends you to the right gastgroenterologist, you might be able to avoid the hospital charges, altogether. The downside of a sigmoidscopy, is that if the GI doc doesn't know what he is looking for, he might take the biopsies from the wrong locations, and completely miss the scattered patches of inflammation that are characteristic of MC. A GI doc experienced in diagnosing MC, however, should be able to utilize a sigmoidiscopy to diagnose MC with reasonably good success.
That pediatric classification might only be a policy of that particular hospital/clinic, also. You might need to shop around.
If worse comes to worse, many hospitals are willing to set up a payment plan on an installment basis, which would help to cushion the financial impact.
There may be other possibilities, such as local programs, (county, city, or even hospital programs), designed to assist uninsured patients who are in need of expensive tests. Maybe someone else may be aware of other programs that might be available in your state, or your county. The key to keep in mind is that there probably won't be any programs available to assist in the diagnosis of MC, (since most GI docs unfairly consider it to be a nuisance disease), but programs are often available to assist in cancer screening or detection, and cancer is something that usually needs to be ruled out for a patient with chronic diarrhea. Or, there might be a program available to assist in the diagnosis of Crohn's disease or UC, which are also possibilities for any patient presenting with chronic diarrhea, and these diseases might need to be ruled out by means of a colonoscopy.
I hope that some of this is helpful.
Tex
Your situation is not all that unusual, and conventional practices can make life pretty tough for those of us in that situation. There are a few programs available that you might be able to take advantage of. For example, if you happen to live in either King or Clallam county, and your doctor is willing to classify your need for a colonoscopy as a test to rule out possible cancer, (which is certainly not unreasonable, since colon cancer is a primary cause of diarrhea), thanks to a three-year federal grant, community clinics in those two counties can refer patients to gastroenterologists for free colonoscopies. The program, however, is available only in King and Clallam counties. Patients must be uninsured and have incomes below 250 percent of the federal poverty level, or $26,000 for a single person and $53,000 for a family of four.
http://seattletimes.nwsource.com/html/h ... er31m.html
If you can't qualify for that program, then the second-best option would probably be to opt for a flexible sigmoidoscopy, rather than a colonoscopy. A sigmoidscopy does not require sedation, and can be performed in a doctor's office in 20 minutes or less. Even if done in a hospital, the cost of a sigmoidoscopy should be significantly less than the cost of a colonoscopy. If your doctor sends you to the right gastgroenterologist, you might be able to avoid the hospital charges, altogether. The downside of a sigmoidscopy, is that if the GI doc doesn't know what he is looking for, he might take the biopsies from the wrong locations, and completely miss the scattered patches of inflammation that are characteristic of MC. A GI doc experienced in diagnosing MC, however, should be able to utilize a sigmoidiscopy to diagnose MC with reasonably good success.
That pediatric classification might only be a policy of that particular hospital/clinic, also. You might need to shop around.
If worse comes to worse, many hospitals are willing to set up a payment plan on an installment basis, which would help to cushion the financial impact.
There may be other possibilities, such as local programs, (county, city, or even hospital programs), designed to assist uninsured patients who are in need of expensive tests. Maybe someone else may be aware of other programs that might be available in your state, or your county. The key to keep in mind is that there probably won't be any programs available to assist in the diagnosis of MC, (since most GI docs unfairly consider it to be a nuisance disease), but programs are often available to assist in cancer screening or detection, and cancer is something that usually needs to be ruled out for a patient with chronic diarrhea. Or, there might be a program available to assist in the diagnosis of Crohn's disease or UC, which are also possibilities for any patient presenting with chronic diarrhea, and these diseases might need to be ruled out by means of a colonoscopy.
I hope that some of this is helpful.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I didn't have a colonoscopy for a couple of years after the D started... my family doc had no clue what was wrong.. but was willing to try to treat the symptoms. I must have used lomotil for a couple of years. Get up .. hit the john three or 4 times.. take one lomotil.. if I ran to the john again.. took anohter one. I was good to get out of the house for several hours and I stopped losing weight. I was tired all the time because that is what lomotil does to me..makes me sleepy.
My husband lost his job a couple months after the D hit. Fortunately we still had insurance.. but without income and a diaper need that would rival a newborn.. things were tight. I went for the cheap lomotil treatment...
Since my D came after taking the visicol colonoscopy prep.. I will not willingly ever do another one. NOTHING showed up on the exam after the visicol prep.. and after extreme D the colonoscopy was done done without prep a couple years later that provided my diagnosis..done at by a specialist who was a professor and researcher.
I did try the gluten free diet... and found it extremely expensive... more expensive than my cost for entocort with insurance.
I don't know how old you are..but your weight seems awfully low, so I can see why the doctor wants to have it done in a facility with full medical backup.
Being sick and being low on funds is a double whammy! The plus for me was that being out of work..my husband could take me to doctor visits... the minus was... heck they had no clue what was wrong and I would end up back with the family doctor who tried his best to keep me as healthy as possible.
If you do find a way to get a colonoscopy... make sure you have a doctor who knows about collagenous colitis and microscopic and celiac disease. The last thing you want is a doctor who knows nothing to do the procedure and then only receive a useless IBS diagnosis!
My heart goes out to you... I know what you are dealing with..
grannyh
My husband lost his job a couple months after the D hit. Fortunately we still had insurance.. but without income and a diaper need that would rival a newborn.. things were tight. I went for the cheap lomotil treatment...
Since my D came after taking the visicol colonoscopy prep.. I will not willingly ever do another one. NOTHING showed up on the exam after the visicol prep.. and after extreme D the colonoscopy was done done without prep a couple years later that provided my diagnosis..done at by a specialist who was a professor and researcher.
I did try the gluten free diet... and found it extremely expensive... more expensive than my cost for entocort with insurance.
I don't know how old you are..but your weight seems awfully low, so I can see why the doctor wants to have it done in a facility with full medical backup.
Being sick and being low on funds is a double whammy! The plus for me was that being out of work..my husband could take me to doctor visits... the minus was... heck they had no clue what was wrong and I would end up back with the family doctor who tried his best to keep me as healthy as possible.
If you do find a way to get a colonoscopy... make sure you have a doctor who knows about collagenous colitis and microscopic and celiac disease. The last thing you want is a doctor who knows nothing to do the procedure and then only receive a useless IBS diagnosis!
My heart goes out to you... I know what you are dealing with..
grannyh
My MC was diagnosed via a sigmoidoscopy which was done outside of the hospital in a medical facility. I've never had a colonoscopy done in a hospital - my GI always does it in the medical facility. It's cheaper outside of the hospital. I don't know if that would be possible given your low weight, but it's worth asking.
Gloria
Gloria
You never know what you can do until you have to do it.
AntWell the weight seems to be the absolute determining factor. I have always been petite (4"9") and my normal/average weight has always been 75-79 lbs. So getting up to over 85 lbs is difficult and I'd actually be pudgy at that weight. I only weighed 97 while pregnant.
What baffles me is that I'm 55 and have already had 3 prior colonoscopies and this weight issue has never come up before. So I am going to start my detective work tomorrow and find out what I can find in surrounding counties to see if there are other options. My last procedure was done in King County and I will start with the endoscopy clinic there to see if their rules are the same. I didn't weigh 85 lbs then either and they still did it.
I am pretty sure the Dr.'s liability insurance is driving this whole issue. But it seems pretty unfair that just because I'm small in stature that I should have to pay $4000-8000 as compared to $840 if I was 5' and 100 lbs. I just don't fit their "normal" ranges--but I never did before.......
I can live with my $1500 deductible, but the excess is the killer. I may see if my state has a medical ombudsman that has any options.
The Entocort has made a huge difference in my life, but I'd say about 70% better--not yet normal. I am buying it from Inhouse Pharmacy out of Vanuatu since it is only $175 for a month vs $483/mo thru my insurance. Retail is over $1200/mo.
I really do like my new GI Dr. He is very young and much more up on options and treatments than the old school ones I've seen before, so I'd like to stay with him, but that my not be possible if I have to go elsewhere. He's the only one of all of them that acknowledges the possibility of MC and wants to take multiple biopsies and also an endoscopy. So I trust him.
I'll keep you posted on what I find out. Maybe it will help someone else in a similar situation. I'm certain I'm not alone in my battle with the system.....
Thanks everyone for the kind thoughts. The not knowing a real diagnosis is just a bit annoying.
Robin
What baffles me is that I'm 55 and have already had 3 prior colonoscopies and this weight issue has never come up before. So I am going to start my detective work tomorrow and find out what I can find in surrounding counties to see if there are other options. My last procedure was done in King County and I will start with the endoscopy clinic there to see if their rules are the same. I didn't weigh 85 lbs then either and they still did it.
I am pretty sure the Dr.'s liability insurance is driving this whole issue. But it seems pretty unfair that just because I'm small in stature that I should have to pay $4000-8000 as compared to $840 if I was 5' and 100 lbs. I just don't fit their "normal" ranges--but I never did before.......
I can live with my $1500 deductible, but the excess is the killer. I may see if my state has a medical ombudsman that has any options.
The Entocort has made a huge difference in my life, but I'd say about 70% better--not yet normal. I am buying it from Inhouse Pharmacy out of Vanuatu since it is only $175 for a month vs $483/mo thru my insurance. Retail is over $1200/mo.
I really do like my new GI Dr. He is very young and much more up on options and treatments than the old school ones I've seen before, so I'd like to stay with him, but that my not be possible if I have to go elsewhere. He's the only one of all of them that acknowledges the possibility of MC and wants to take multiple biopsies and also an endoscopy. So I trust him.
I'll keep you posted on what I find out. Maybe it will help someone else in a similar situation. I'm certain I'm not alone in my battle with the system.....
Thanks everyone for the kind thoughts. The not knowing a real diagnosis is just a bit annoying.
Robin
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Gabes-Apg
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- Joined: Mon Dec 21, 2009 3:12 pm
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Robin
keep on the investigations and try to negotiate a solution that works (and fits the budget)
getting an acurate diagnosis is very important, it is such a shame it is such a stressful process
you are what you are -
it cheeses me off when decisions are made based on if you 'fit' a tick box check sheet
if you have never been that weight, and have had procedures before without issues, why is that not enough
and wow - getting entocort from Vanuatu.... I hope it smells of frangipani's
good luck
Gabes
ps - I am never going to complain about our health system ever again!
keep on the investigations and try to negotiate a solution that works (and fits the budget)
getting an acurate diagnosis is very important, it is such a shame it is such a stressful process
you are what you are -
it cheeses me off when decisions are made based on if you 'fit' a tick box check sheet
if you have never been that weight, and have had procedures before without issues, why is that not enough
and wow - getting entocort from Vanuatu.... I hope it smells of frangipani's
good luck
Gabes
ps - I am never going to complain about our health system ever again!
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
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Joefnh
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- Location: Southern New Hampshire
Robin I am glad that you may have some options to pursue in keeping the cost down. I agree with the younger doctors, as I had recently switched and my new doctor is quite up to date including the gluten free diet, which he gave me an article on during our last appointment. That quite a change from my first GI who did not want to prescribe Entocort, even with Crohns.
The Entocort is also working quite well for me and I am now adopting Gabes meal plan to begin the GF/LF/LF diet to allow the healing process to go even faster.
Good luck and keep pushing and looking for better options. Remember the squeaky wheel gets the oil...
-Joe
The Entocort is also working quite well for me and I am now adopting Gabes meal plan to begin the GF/LF/LF diet to allow the healing process to go even faster.
Good luck and keep pushing and looking for better options. Remember the squeaky wheel gets the oil...
-Joe