Colonoscopy

What is a colonoscopy?

A colonoscopy is an examination of the large intestine (colon) and rectum to look for swollen, irritated tissues, polyps, or cancer. The doctor may remove polyps or other abnormal tissues or collect tissue samples (biopsies) for further testing. Patients typically undergo a colonoscopy to investigate and/or treat intestinal issues or to screen for colon cancer. It is generally recommended that adults aged 45 and older receive a colonoscopy.

What are my colonoscopy benefits under my Sidecar Health plan?

Your plan’s Benefit Amounts are visible in the Sidecar Health member portal through Care search. Your Member Care team is available to help you navigate your benefits for each option. For more detailed information and to understand your benefits, please submit a pre-bill to Sidecar Health. 

Note, the below medical codes (sometimes referred to as CTP, DRG, or procedure codes) are often included during a colonoscopy, but services and procedures included vary from doctor to doctor. Ask your doctor what services will be included for the most information on how much your plan will pay.

What should I remember when shopping for a colonoscopy?

• It’s important when choosing your gastroenterologist you understand what options are available for the procedure. Many doctors perform colonoscopies at offices and ambulatory surgery centers, which generally have lower prices. Other doctors may only use higher-cost settings, such as hospital outpatient departments.
• A colonoscopy typically includes several providers and services – make sure to get quotes for the provider (gastroenterologist), the location of the procedure, (office, ambulatory surgical center, or hospital outpatient department), the anesthesia, and any pathology.
• It is unlikely that your provider will know in advance whether a biopsy or polyp removal will occur, so be sure to ask for estimates in advance and include them in your pre-bill.
• Submitting a pre-bill to Sidecar Health is the best way to get an accurate estimate of your Benefit Amounts – ask your provider for a detailed itemized estimate.
• Sidecar Health members have had great experiences shopping for affordable colonoscopies with ColonoscopyAssist – visit our FAQ article or their website for more information on options available near you*. 

*Sidecar Health provides external links for convenience and informational purposes only. Sidecar Health bears no responsibility for the accuracy, legality or content of the external sites or for subsequent links from an external site.