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).
Plan Enrollment
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.
Get all HR news, benefits insights, and upcoming professional development opportunities, follow the HR Blog.
Discover more from Human Resources
Subscribe to get the latest posts sent to your email.