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Subject:

So I'm currently having a disagreement with my previous insurance company

From: Wahoo Find all posts by Wahoo View Wahoo's profile Send private message to Wahoo
Date: Mon, 08-Jan-2024 5:26:46 PM PST
Where: SoapZone Community Message Board
In reply to: It's the Monday/Tuesday/Wednesday chat post!!! posted by Bunky
Back in the fall of '23, my doctor recommended a colonoscopy. I'm...not quite ready for that (I know, I know), but I *did* agree to take the Cologuard test. All went well and the test results came back perfectly fine, hence it remained a routine preventative test and not a diagnostic test. So I assumed my insurance company--"IC"--would pay for it, as I'd read on their website that they cover preventative tests. I know I didn't have to pay for a mammogram when I was with them. I'd also read on the Cologuard website that "most" insurance companies cover the cost of the test.

So you can imagine my surprise when I got a bill for just over $500 in November. Now that insurance ran out at the end of October, and I sent in my test the last week of October. I was concerned that Exact Science Laboratory (ESL) billed based on the date they actually, uh, examined the specimen but when I called ESL (and talked to a VERY lovely woman), I was assured they bill based on the date of the test, not the date the contents are actually tested. The rep told me she'd send me a form letter to send to IC, explaining that I thought I shouldn't have to pay for Cologuard, and I didn't have to pay my bill until I heard from IC.

I just got a letter from IC Saturday and nope, they're not paying. They told me it was because I'd not met my (very high) deductible. That's true but I don't recall seeing anything saying the test was only free after the deductible was met. They also sent me a form saying I could request an external review, which...just seems like a lot of effort. But at the same time, $500 is a lot of money, especially when you're not working. I'm debating what to do next.

My usually law-abiding dad suggested I just not pay ESL for my Cologuard test. My aunt once refused to pay a (smaller) medical bill and eventually, the subject was dropped. She never paid the bill and nobody ever said anything to her after, oh, the third attempt or so to collect. Anyone else have any experience with a similar situation, or any advice on what to do?


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