Understanding the Affordable Care Act


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We are all looking forward to the Affordable Care Act. At the same time, we are hoping that someone will be around to tell us how it relates to us. Let's face it. The administration didn't do a very good job of selling it or explaining it. Each of us is figuring out how it will apply to us as small issues surface. We know that our kids can stay insured until 26, and we know as cancer survivors that our history can't be used against us. Today there was a good piece in the Kaiser Health News feed that is available through email sign up. There are a number of these health care feeds available, and to be a knowledgeable consumer, I recommend you find them and sign up. Today they focused on screening tests for colon and rectal cancers. Most health plans cover preventive health services if it's one of those recommended by the U.S. Preventive Services Task Force, and since colorectal cancer is the second leading cause of cancer death in the United States, it is one of those covered. Finding colon cancer early is the key to survival and that means removing polyps discovered during a colonoscopy before they turn into cancer. The colonoscopy is one of those tests that should not cost the patient anything – unless, of course, polyps are found and removed, and that's when it gets complicated. Because if polyps are removed to see if they are cancerous, the test can then be judged to be therapeutic or diagnostic rather than screening, and the patient can be billed for the cost – around $2,000 or more. Right now, half the people who get screening colonoscopies have polops removed.And what about patients who have a positive fecal occult blood test before their colonoscopy? Is that colonoscopy part of the screening process or diagnostic? And what if they have a family history? In February, according to Kaiser, the government clarified that high-risk patients who qualify for more frequent screening should not have to cost share. Take the time to educate yourself on the specifics so you will know what you do and do not have to pay for.

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