Colonoscopy, did something change?

[vic120]

I never once got a call till this year on any issue getting everything covered on colonoscopy since I started in this buis

But this year I have got 3 or 4 calls already, Actually all within the last 2 weeks

saying they have to pay $150 -$200 for prepkit


is this something new, is it a new way of doing it or a new way its covered are they supposed to bill medicare but now billing drug cov

I have never got a call before this year on this so I never had to think on exactly how it was covered just assumed it was 100% converted as no one complained and now they are complaining much

 

[Millwood]

Fill at pharmacy. Part D will cover it.

Just a new revenue source for provider.
Similar to cataract surgery charging for antibiotics, eye drop goody bag , instead of giving patient a prescription their Part D would cover.

 

[vic120]

Fill at pharmacy. Part D will cover it.

Just a new revenue source for provider.
Similar to cataract surgery charging for antibiotics, eye drop goody bag , instead of giving patient a prescription their Part D would cover.

Yes its tier 4 out of pocket I am hearing $150 t $200

In the last 10 years no one has asked or complained about this I would assume this is new because someone would have complained if they had to pay out of pocket like that in the past

I had 4 calls in last 2 weeks and never before

Seems strange if nothing changed something has to be different

I've always seen out of pocket for cataract accessories

 

[ICACharleston]

MA or MedSups? Any particular carriers?

 

[vic120]

MA or MedSups? Any particular carriers?

Med Supp PDP all the callers same

All callers in last few weeks

None yet on MA Plans

they says its covered PDP tier 4 which obviously is deductable with most PDPs unless there are a lot of names or high tier drugs to cover

 

[somarco]

It is the Rx the docs are prescribing.

Not too long ago they would suggest Miralax and similar OTC med's. Now they will often prescribe Suprep.

Don't run it through your PDP. Pay cash, use GoodRx, etc . . . it's $120

https://www.goodrx.com/suprep-bowel-prep

Or ask your doc if you can take Miralax (about $25)

 

[fed up]

Needymeds.org has a mail in for a free prep kit, no insurance requirement

 

[somarco]

Needymeds.org has a mail in for a free prep kit, no insurance requirement

This?
Coupons, Rebates & More | NeedyMeds

 

[billyb]

I am due for my next colonoscopy in August. Last time I had 1 polyp and the cost went from $0 to $4000+ with Florida Blue. If I wait until I enroll in Medicare Parts A & B in February 2022 will this cover all cost even if they find a polyp?

 

[Chazm]

I am due for my next colonoscopy in August. Last time I had 1 polyp and the cost went from $0 to $4000+ with Florida Blue. If I wait until I enroll in Medicare Parts A & B in February 2022 will this cover all cost even if they find a polyp?

Just A & B? You would owe the part b deductible and 20%