Women hit with unexpected nearly $ 2,000 bill for colon cancer screening

Popular home tests for colon cancer have unexpected effects for some people and may delay life-saving treatment. Instead of the much more complex process of colon endoscopy, Americans may be used to seeing an advertisement for Cologard, a home exam that is touted as a way to screen for colon cancer at home. do not. Experts say it’s a good screening tool, but some users say they’ve had to deal with high bills.

Missouri-based Lianne Bryant told CBS News consumer research correspondent Anna Werner that she was intrigued after watching a Cologuard ad on television for several years.

“I was like, ‘Hey, this home screening that I can do looks pretty easy compared to a full-blown colonoscopy,” “Bryant, 55, told CBS News. ..

She called the insurance company in August and asked about Cologard.

“They said, ‘Yes, it will be fully covered’ because I didn’t want to get caught up in an unexpected bill,” she said.

She sent a sample and waited for an email with the results. To Brian’s surprise, the test came back positive.

“I can have polyps and I can have colon cancer,” she recalls.

Brian eventually needed a colonoscopy, but was relieved to have negative results.

After that the bill started to come in.

“I started getting reports from my hospital that I had a balance of $ 1,900,” said Bryant. “Well, I sure don’t think I’m borrowing so much, which is to say it’s impossible.”

Colon cancer is very curable if caught early. Colonoscopy is provided free of charge to most people 45 years and over..

under Affordable method of careHis colonoscopy was coded as a “diagnostic” test because Bryant’s Cologard test was positive, only for regular screening tests, but his insurance covers it completely. It was not covered.

If she hadn’t used Cologard in the first place, she would have been completely covered.

“I’m angry because I’m paying a lot of money for this insurance every month,” said Bryant. “I feel like I’m really picked up.

CBS News polled 11 of the largest health insurance companies in the United States to see what they would do in a situation similar to Brian’s. Seven did not respond. Coverage decisions vary, and the amount a consumer pays depends on how the doctor codes the colonoscopy procedure.

“Unfortunately, in some cases, people who test positive for non-invasive tests like Cologuard have to pay for the colonoscopy at their own expense,” he said, studying the pricing of medical services. said Dr. Mark Fendrick of the University of Michigan.

Fendrick is concerned that if he learns the colonoscopy may not be covered, he may not be able to have a colonoscopy at risk of developing colon cancer. I have.

“People who appear to be at high risk, that having a colonoscopy isn’t easy economically or otherwise doesn’t make sense to me,” he said.

Cologuard is manufactured by Exact Sciences. Kevin Conroy, chief executive officer of the company, agrees there is a problem.

“If a person receives a bill related to testing, it is too much,” he said.

“Millions of patients have access to this follow-up colonoscopy at no cost, but not all,” said Conroy, requiring the addition of a new language to the website. He said he decided there was.

“You brought up that has helped us, helped highlight what we can do better, and we’re always looking for ways to improve,” he told CBS News. ..

However, frequent TV commercials show that the cost of Cologard itself is covered by most insurance policies, but mention that follow-up colonoscopy may not be covered. I do not have.

Conroy defended the commercial by calling it “appropriate.”

“If what you’re doing is preventing people from being fully tested, there is a significant cost associated with that,” he said.

Lianne Bryant would have liked these ads to warn her.

“I don’t mean to say it’s wrong, but in a way I only use people. If this happens to me, I know it will happen to a lot of people, ”said Bryant.

Researcher Dr Fendrick believes that advertising issues are not a problem if all colon cancer screening is to be covered by insurance.

“I hope your story educates not only your watchers, but also payers, and they know how absurd this policy really is,” Fendrick said. ..

Cologuard has a program to help people appeal for unexpected follow-up colonoscopy requests. Brian eventually won his claim for the insurance company to pay a bill for $ 1,900, but it took five months for that to be resolved.