QUESTION

I thought a colonoscopy screening was a free preventive service. When I went in for my screening, an abnormal growth or polyp was found and removed. I just received a bill for the removal of the growth. What can I do?

Post enrollment issues | Individual Health Insurance
ANSWER

Under an ACA plan, this is considered a recommended preventive service and must be covered without any cost-sharing to you. You can appeal this claim starting with the internal appeals procedure your insurer must provide you. Federal guidance currently requires insurers to cover the removal of any growths or polyps removed during a colonoscopy performed as a screening procedure. (CMS, Affordable Care Act Implementation FAQ – Set 12, Feb. 20, 2013).

Individuals with no coverage
Individuals with coverage
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Post enrollment issues