Insurance

Insurance provider switched policy a week after patient complains

Jennifer Beane was set to get a colonoscopy last February. The plan changed when she learned her insurance company would not cover the cost.

GREENSBORO, N.C. — Jennifer Beane is pretty good about getting her annual physical. The soon-to-be 46-year-old was visiting her doctor earlier this year when the doctor told her to get a colonoscopy.

“My physician stated you are almost 46 now and they have lowered the age for colon cancer screening to 45. You really need to get this done,” Beane said.

This is not the first time Beane had been told she should have a cancer screening. News 2 anchor Julie Luck announced that she had a colonoscopy in January and learned she had cancer. Luck encouraged everyone 45 years or older to be screened.

“I’ve been following Julie’s story and seen all the stuff on the news,” Beane said.

A few days later, Beane scheduled her colonoscopy for late February. It’s not something you look forward to, but Beane knew it was important and how it could save her life.

“She (my doctor) sent in the referral, and I thought everything was fine,” Beane said.

About three days before the colonoscopy, Beane was informed by the doctor’s office that her insurance was not covering the screening. Beane immediately reached out to her doctor and Blue Cross Blue Shield. Her doctor’s office was not able to provide much information, but Beane did get a call back from a representative from the insurance company.

“They basically told me in no uncertain terms, sorry it’s (colonoscopy) not covered,” Beane said.

New guidelines, for colon cancer screenings, had been introduced at the end of 2021. Some insurance providers had adopted the guidelines and offered free colonoscopies to patients last fall while most of the others offered the screening at no cost at the start of this year.

“My doctor made this recommendation. You need to get this done and now my insurance company is telling me, well you can do it, but we will not pay for it,” Beane said.

A day or so later, Beane reached out to our 2 Wants to Know team about the situation. We did some research and then reached out to a representative from Blue Cross Blue Shield. We sent an email detailing the situation along with a list of several questions about its policy.

The representative told us it would investigate the matter and make sure the correct person was contacted. About a week went by before we received an email and a phone from Blue Cross Blue Shield. The insurance provider informed us they decided to cover 100% of colorectal cancer screenings starting in April instead of June 1. 

“I was blown away at that point. I was so excited I think we both were,” Beane said.

Blue Cross Blue Shield sent us a statement that read in part:

As you know, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) have been working to implement coverage changes for preventive colorectal cancer screenings. Blue Cross NC has always covered colorectal cancer screenings for members. We are pleased to announce updates to coverage of preventive colorectal cancer screenings ahead of new coverage guidelines going into effect nationally. Blue Cross NC will cover colorectal cancer screenings and associated services with no out-of-pocket costs for members ages 45 and older by April 1, 2022, on eligible plans.

Thank you for raising awareness around the importance of colorectal cancer screenings. Colorectal cancer screenings, in addition to many other screenings and tests, are covered at 100% with no out-of-pocket costs to eligible members as part of their health plan. Preventive screenings are one of many things that drive better quality health care for North Carolinians.

As for Beane, she couldn’t help but smile when asked about her decision to fight the initial denial of coverage for her colorectal screening.

“Somebody out there is going to get a colonoscopy now and it will save their life,” Beane expressed.

If you are 45 and older and have not had a colonoscopy yet you are eligible for a free screening through your insurance company.

Julie Luck almost put her screening off. She isn’t high risk, there is no family history of colon cancer, and she lives a very healthy lifestyle. All that didn’t matter and had she waited the outcome could have been much worse.


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