Colorectal cancer is the third most common cancer diagnosis among men and women combined in the United States, but approximately 90 percent is treatable if caught early with a screening.
The U.S. Preventative Task Force recommends adults age 45 to 75 be screened for colorectal cancer. Participants on MSU’s medical plan pays 100% of covered charges for a preventative colorectal screening when provided by an in-network provider. This coverage is extended to less invasive screenings, such as Cologuard.
Diagnostic or preventive?
Knowing the difference between preventative and diagnostic, can help prevent unexpected costs. Below is a “general rule of thumb”; always consult with your physician and feel free to reach out to Med-Pay, for a more information.
- Preventive or screening test is performed on a patient who is asymptomatic (no gastrointestinal symptoms either past or present), is 45 years of age or older, and has no personal or family history of colon polyps and/or colon cancer.
- Diagnostic testing is performed on a patient who has gastrointestinal symptoms (e.g. rectal bleeding, abdominal pain, diarrhea) or who has past and/or present polyps or gastrointestinal disease (e.g. Crohn’s Colitis, etc.).
- If polyps are found, removed or biopsied during a screening colonoscopy, the insurance claim may be recategorized from a screening to a diagnostic with inclusion diagnostic coding (screening benefit may no longer apply).
Critical illness insurance benefits
A potential cancer diagnosis is scary, but early detection can save lives. The Critical illness insurance is of value for both employees and dependents. Employees and/or their dependents enrolled in the Allstate Critical illness plan are eligible to receive a $100 wellness reimbursement for covered wellness/preventative care related activities, including screening colonoscopy. Those enrolled in the plan who receive an invasive cancer diagnosis would receive a benefit of either $10,000 (plan 1) or $20,000 (plan2). Funds are payable directly to the employee and can be used to offset medical costs, or may be utilized as you see fit (e.g. Auto/Home payments, groceries, etc).
Enrollment/Changes can only be made to the Medical and Critical illness plans yearly during open enrollment (November 1- December 1), or within 31 days of a qualifying event.