Why won’t the health plan pay for my colonoscopy?
The Affordable Care Act requires health plans to cover 100% of preventive services without any cost to the consumer. Most plans pay for preventive services recommended by the United States Preventive Services Task Force (USPSTF).
Sometimes, a patient’s medical history will cause a provider to code a colonoscopy as diagnostic because their case falls outside the USPSTF recommendation. If this happens to you, please ask your provider to submit a corrected claim to the insurance plan.
Please contact us with any questions.