[Brandigirl]

I don't know how it works in Florida. In GA if you are under Medicare age and have work issued health insurance and have a positive Colorguard, the coding for the colonoscopy will be "diagnostic colonoscopy or positive colorguard". This means you have to meet your out of pocket deductible first. Most insurance will pay for a "screening colonoscopy", meaning that you either never had a colonoscopy before or you have had a negative colonoscopy in the past. So, according to GI doctors I know in GA, it is better to get a colonoscopy so it can be coded as "screening" as long as you meet the criteria I listed above. Now if you ever had a history of polyps, you will always be coded under history of polyps. So it will always be considered a diagnostic colonoscopy going forward in most cases. Now, if you go in for a "screening colonoscopy" and they find and remove a polyp, call your insurance company (under Medicare age) and let them know you had no history of polyps prior and it was a "screening colonoscopy" and most likely that will not change the coding to diagnostic and it will be covered under your preventative care. Now, things might have changed regarding this so this is just a little background on it.

[Chi-Town]

If I made a living performing colonoscopies I would not be touting Cologuard. 13% positive would not be a big enough set off for the 87% negative. However, at least the 13% would now be getting a colonoscopy

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[Sparty6971]

Originally Posted by hansel

Has anyone NOT GOTTEN a positive result from cologuard? Sounds like a good money making deal.

I did one just a month ago and was negative; procedure is pretty easy but pays to read the instruction manual (yep, a manual) a couple of times to make CERTAIN you do it correctly.

Yes, probably is a money maker. But then what isn't anymore?

[Viperguy]

Saw on tv a Dr. reported that MRI's are now so accurate that they can perform "virtual" colonoscopies cheaper and nearly as accurately as the real one. Medicare won't cover it......big surprise. Medicare for all......hah

[LI SNOWBIRD]

Originally Posted by sam&rog

Saw all the ads on tv and primary care ordered one for me. $649 billed to Medicare.
The results were positive and colonoscopy was needed.
The gastro Doctor gave me a look over her glasses like are you kidding. Hinted that a great number of results are false positive.
Had the procedure and pollops were benign.
So go for the colonoscopy first and save anxiety of false results.

I'm taking the pipe between Thanksgiving and Christmas when we are up North--looking forward to it NOT

[blueash]

Originally Posted by cgilcreast

Saw on tv a Dr. reported that MRI's are now so accurate that they can perform "virtual" colonoscopies cheaper and nearly as accurately as the real one. Medicare won't cover it......big surprise. Medicare for all......hah

Well as an excellent source of accurate information I have always recommended "I saw a guy on tv" or you can do a medical literature search using google scholar or Medline where you will find things like this:

"Current Status of Magnetic Resonance Colonography For Screen and Diagnosis of Colorectal Cancer" published in Sep 2018 which concludes

MR colonography in its current state is not suitable for CRC screening

Perhaps it is scientific consensus and data which Medicare uses to decide whether they should pay for a test. I, and this is only an opinion, do not think Medicare should pay for a test which is not suitable. YMMV.
I am not sure why taking a shot at Medicare for All is included in your post as it has nothing at all to do with whether an MRI is a good test for colorectal screening.

[retiredguy123]

Originally Posted by cgilcreast

Saw on tv a Dr. reported that MRI's are now so accurate that they can perform "virtual" colonoscopies cheaper and nearly as accurately as the real one. Medicare won't cover it......big surprise. Medicare for all......hah

It makes sense to me that Medicare won't pay for a virtual colonoscopy because, if they find polyps, then you need to get a regular colonoscopy to have them removed. So, you have greatly increased the screening costs, by adding another expensive procedure.