Popular home tests to detect colon cancer come with unexpected costs for some. Which led to fears they might postpone life-saving treatment. Americans may be familiar with watching ads for Cologuard, an at-home test that is advertised as a way to detect colon cancer at home. Instead, the procedure involves a colonoscopy. Experts say it’s a good screening tool. But some users said they face high costs.
Missouri resident Lianne Bryant told CBS News consumer investigative correspondent Anna Werner she was intrigued after two years of seeing Cologuard commercials on television.
“I thought, ‘Hey, the home screening I can do sounds pretty simple compared to a complete colonoscopy,'”
; Bryant, 55, told CBS News.She called her insurance company in August to inquire about Cologuard.
“They said ‘yes, it will cover all’ because I don’t want to be caught with an unexpected bill,” she said.
She sent a sample and waited for an email with the results. Bryant’s surprise The test came back positive.
“I can have polyps. I could have colon cancer,’ she recalled thinking.
Bryant needed a colonoscopy. but was relieved that the test result came out negative.
Then the bills began to arrive.
“I started getting statements from my hospital saying I had a balance of $1,900,” Bryant said. “I thought I didn’t owe that much. I mean it’s impossible.”
Colon cancer is highly curable if detected early. Most people have a colonoscopy service free of charge. over the age of 45.
under Affordable Care ActIt covers only routine screening tests. And because Bryant’s Cologuard effect is positive. Her colonoscopy was therefore coded as a “diagnostic” test, which her insurance didn’t cover at all.
She would be fully protected if she hadn’t used the Cologuard first.
“I’m really angry because I pay so much every month for this insurance,” Bryant said. “I just feel like I’m really being wiped out.”
CBS News surveyed 11 of the largest health insurance companies in the United States to see what they would do in situations like Bryant Seven did not respond to. How much consumers will pay depends on how their doctor prescribes the colonoscopy procedure.
Dr. Mark Fendrick from the University of Michigan “Unfortunately, in some cases Those with a positive, non-invasive test, such as a colocard, will have to pay pocket money for a colonoscopy.”
Fendrick worries that when people find out, colonoscopy may not be comprehensive. they will not receive Even if they are at risk of colon cancer.
“The fact that people are considered high risk That it wasn’t easy financially or otherwise to get a colonoscopy didn’t make sense to me,” he said.
Cologuard is made by Exact Sciences. Kevin Conroy, the company’s chairman and CEO, agrees there’s a problem.
“If one receives a bill related to screening It shows that there are too many people alone,” he said.
Conroy said his company decided it needed to add a new language to its website. By saying that although “Millions of patients will be able to access this follow-up colonoscopy at no cost, but not all of them.”
“You add this to help us. Help highlight what we can do better. So we are always looking for ways to improve,” he told CBS News.
However, although the frequent TV commercials note that Cologuard’s costs are covered by most insurance policies, they are not. They did not mention that subsequent colonoscopy may not be comprehensive.
Conroy defended the messages in the ads by calling them “appropriate.”
“If all you’re doing is totally terrifying people from getting screened. There are huge costs involved in that,” he said.
Lianne Bryant said she hoped those ads would warn her.
“I don’t want to say it’s a hoax. but in a way It’s just taking advantage of people. if it happened to me I know it’s going to happen to a lot of people,” Bryant said.
Researcher Dr. Fendrick believes that any problem With ads, it doesn’t matter if insurance needs to cover all colon cancer screenings.
“I hope your story will not only raise awareness among your viewers. But also among payers to make them see the policy as really unreasonable,” Fendrick said.
Cologuard has a program to help people file an appeal if they receive an unexpected bill for a follow-up colonoscopy. Bryant eventually won her appeal to get her insurance company. Pay her $1,900. But it took her five months to fix it.
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