Colonoscopy Without Insurance: How to Minimize the Cost and Where to Get Financial Help
Colonoscopies are the first line in defense against colorectal cancer due to the procedure’s ability to identify abnormal tissue growth before cancer develops. If you are over the age of 50, a colonoscopy can help save your life. However, if you do not have insurance, the cost alone can keep you from completing a colonoscopy screening. For people without insurance and are able to qualify, there are government assisted-plans that help to cover the cost of a screening colonoscopy. Do not be discouraged if you do not qualify for these programs. There are many programs and options that offer assistance for people who do not have insurance and are unable to receive this government assistance.
For instance, you can check with your state’s public health organization and colon cancer organizations to inquire about receiving assistance through privately funded programs. Further, there are colonoscopy assistance programs that offer patients who are not insured discounts and reduced financing options with a flat fee for the entire procedure. Other options to finance your colonoscopy include joining a concierge medicine group or consulting your bank or credit union to get a private loan. Beyond these financing options, you can minimize the cost of a colonoscopy by spending a little extra time researching different medical clinics, hospitals, and private offices to find the most affordable option. Read further to explore the options available for you locally and online to help you cover the costs.
How to Minimize the Cost of a Colonoscopy
A colonoscopy can range in cost quite considerably depending on many factors, including where the facility where you have your colonoscopy and if the physician finds abnormal tissue during the procedure. While the average cost of a colonoscopy is around $3000, the procedure can range from $1750 to $10,000 for patients without insurance. The Affordable Care Act mandated that when being screened for colorectal cancer, insured and Medicaid patients qualify for a free colonoscopy. Therefore, insured patients can expect to pay no more than $1000 deductible. Unfortunately, if you are uninsured you do not qualify for a free screening colonoscopy.
The Affordable Care Act mandated that when being screened for colorectal cancer, insured and Medicaid patients qualify for a free colonoscopy. Therefore, insured patients can expect to pay no more than $1000 deductible. Unfortunately, if you are uninsured you do not qualify for a free screening colonoscopy.
The common out of pocket cost for a colonoscopy alone is $2000, but there are additional fees that can add to your total payment. Yet, there are ways for you to cover the cost and minimize the cost. These include:
Financial aid. Many hospitals and clinics have financial aid programs that often offer discounts or interest-free payment plans. There is also financial assistance available through organizations such as the Colorectal Cancer Alliance who offer low- or no-cost screenings to those in need. Before you schedule your colonoscopy, ask if the facility offers financial aid or reduced fees and if they have interest-free payment programs.
Colonoscopy assist programs. In some cases, a colonoscopy can cost upwards of $3000, especially if you need a polyp removal. Colonoscopy assist programs can help to reduce the overall cost of your colonoscopy significantly. These programs typically offer an all-inclusive rate for a colonoscopy at participating healthcare facilities throughout the United States. The flat rate for the colonoscopy includes physician, pathology, and facility fees as well as the cost of the sedation and any removal of polyps or taking a biopsy that occur during the procedure.
Medical loans. Unsecured personal medical loans allow you to borrow money with putting up collateral. There are online medical loans you can apply to that are easy to get if you have good credit. Your local bank and credit union can also provide you with a medical loan. However, if you have poor credit, you may not be able to acquire an unsecured personal loan. Also, loans often have high interest rates if you do have a low credit score.
Medical credit card. These cards often have a 0% APR for 6-18 months and you are able to pay off the loan with time. Keep in mind that if you do not pay off the credit card in the grace period you will be charged for all interest accrued since you opened the card.
Shop around. Before you go in for a colonoscopy, shop around to find the most affordable option for you. Hospitals and clinics are required by the Centers for Medicare and Medicaid Services to publish price lists online for common procedures such as a colonoscopy. If this information is difficult to locate, you can also call hospitals, surgery centers, and gastroenterologists to compare the cost of services and related costs. Ask specifically about the following costs:
- Consultation fee before the procedure
- Physician’s fee
- Sedation or anesthesia fees
- Pathology fees (including the cost of a polyps removal and biopsy)
- Facility fees
Cost Breakdown of a Colonoscopy Without Insurance
The following is a cost breakdown of a colonoscopy without insurance. Remember that the total price of your colonoscopy will vary depending on various factors, including the region where you live, the facility you choose to have the procedure done, and if you have to have a polyp or adenoma removed. Some hospitals and clinics will charge a flat fee for the colonoscopy. For example, Kaiser Permanente charges $898 for a diagnostic colonoscopy and $1291 for a colonoscopy with removal of abnormal tissue. This cost typically does not include additional fees. Consider the following costs that may not be included in the flat fee.
Bowel preparation kits: $9-$120
Consultation fee: $80- $250
Anesthesia/sedation: $250 or more depending on sedation complexity
Pathology: $50 – $100
Polyp removal: $200 – $300
If you have a choice between getting your colonoscopy at a hospital or an ambulatory surgery center, choose the ambulatory center as they often charge half the cost for the procedure and facility fee. Consider the following colonoscopy fees when choosing the facility:
Hospital facility cost: $5630 with a professional fee of $670
Ambulatory surgical center facility cost: $2,350 with a professional fee of $679
Independent endoscopy center facility cost: $2,300 with a professional fee of $570
If you are uninsured, you may consider using concierge medicine to pay for your medical costs. This health care model requires the patient to pay a fee either every month or once or twice per year. Similar to a retainer you would pay to keep your lawyer, concierge medicine means you visit your physician for a flat fee for the entire year and visit as many times as you wish. Compare this to a traditional practice where you will need to pay your physician per appointment and any form of treatment that accompanies these appointments. In this network of medical providers, you are able to visit a specialist, such as a gastroenterologist, for no additional fees if you are referred by your concierge physician.
If you do not have insurance, you may find that paying for a concierge plan may be less than paying out-of-pocket costs for any medical appointment, treatment, or procedure you need through the year, including a colonoscopy.
If you do not have insurance, you may find that paying for a concierge plan may be less than paying out-of-pocket costs for any medical appointment, treatment, or procedure you need through the year, including a colonoscopy. An annual fee to subscribe to concierge medicine can cost between $1200 and $3000 or more if you are paying for high-end private medicine. Many concierge programs will include important screening procedures in their annual fee and at no extra cost to you. Keep in mind that some concierge programs can run quite expensive and you should shop around to find the one that best fits your needs.
Castaneda, R. (2020, November 16). What is concierge medicine? Retrieved from U.S. News and World Report: https://health.usnews.com/wellness/articles/what-is-concierge-medicine
Colonoscopy Assist Writing Staff. (2021). Nationwide colonoscopy program. Retrieved from ColonscopyAssist: https://colonoscopyassist.com/program-details/colonoscopy/
Colorectal Cancer Alliance. (2021). Financial assistance programs. Retrieved from Colorectal Cancer Alliance: https://www.ccalliance.org/patient-family-support/financial-assistance-programs
Howmuchguide Writing Staff. (2021). How much does a colonoscopy cost? Retrieved from Howmuchguide: https://howmuchguide.com/colonoscopy-cost/
Kaiser Permanente Staff. (2020). Kaiser Permanente Sample Fee List. Retrieved from Kaiser Permanente: http://info.kaiserpermanente.org/info_assets/estimating_your_cost/PDFs/422084200_OE-SCAL-Sample-Fees-List_MER_SCAL_2019_RS_ENG_r2f_PRE-ATC_DG_ADA.pdf