When my doctor recommended mine, she said that they could do screening but if they found anything, they would have to do a colonoscopy and then it wouldn’t just be covered as screening (since it was an incident rather than preventive at that point). She said it was better just to get the colonoscopy due to health insurer rules.

If they find something suspicious during the colonoscopy, they won't bill it as a free screening anymore and you'll be on the hook for it. Ask me how I know.

No regrets about getting screened though. It saved my life.

Sorry, I meant: if you do a non-colonscopy screening first and they find something, the follow up colonscopy isn't covered as preventive. And the non-colonscopy screenings have a higher false positive rate than a colonscopy screening.

Good to know. I was just adding to what you said that even if you don't get a positive result before a colonoscopy, the colonoscopy might not be covered as preventative care. Insurance just really doesn't want to cover it.

> It wouldn’t just be covered as screening (since it was an incident rather than preventive at that point). She said it was better just to get the colonoscopy due to health insurer rules.

Well yeah...it isn't screening then. It's a treatment. So the question becomes whether or not the treatment is necessary. If the prior "screening" didn't show definitive evidence that the treatment is necessary, then...what are you doing, exactly?

I understand that colonoscopies mix up the notion of treatment and screening, but the doctor is basically saying "our screening tests don't work very well, so we should just do the treatment without evidence because they'll pay for that."

My father's mother had it. My mother's father died of it early. I am predisposed.

Fair enough. I'm making a broader argument than just your situation (which obviously I don't know). The insurance companies are not crazy for trying to control costs on this kind of stuff...however ham-handed their methods.

>The insurance companies are not crazy for trying to control costs on this kind of stuff...however ham-handed their methods.

At some point, after so many failures and edge cases, the least they can do is be actual humans and ask themselves "are we the baddies?"

I get that, but my point is that in health insurance, you're pretty much always going to find someone complaining about being denied for something, even if the denial was completely justified on an evidentiary basis (again: not talking about OP specifically here). Literally every cost-control measure -- even if sensible -- is going to be framed as evil by someone.

A lot of health care is just really expensive superstition. For a more extreme version, consider the phenomenon of "preventative MRIs", which are just lighting piles of money on fire for no reason at all.

I replied to colonoscopy specifically here because the general public has been conditioned to believe that these screenings are medically necessary at increasingly younger ages for everyone, despite the fact that this is not the standard at all in most other countries.