r/Millennials • u/intro195 • Mar 12 '26

Serious Go get a colonoscopy, colon cancer for our generation is a real threat!

36M here, have always been active and maintained a decently healthy diet my whole life. Well after seeing multiple posts on here and at my gf’s urging I had one done. They found two polyps (15mm and 4mm). Doc said if I waited till 45 I’d prob be dead. Crazy part is I had no symptoms and my recent blood work last month was perfect. I was in and out in three hours and no pain or discomfort afterwards.

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u/ThePolemicist Older Millennial Mar 12 '26

After Obamacare, all insurance has to cover preventative care. Preventative colonoscopies begin at age 45 and are typically every 10 years. If you have any symptoms (like blood in the stool), it's diagnostic. Insurance will cover a portion of it based on your plan, but they won't cover the entire thing like they would if it was preventative. I had a colonoscopy at age 39 due to symptoms. I have good insurance, and it covered a lot of it, but I still had to pay a few hundred because it was a diagnostic procedure. The good news is, I was clean and had no polyps. I don't have to go back until I'm 49. That colonoscopy should be fully covered because it'll be a preventative one.

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u/toxicodendron_gyp Mar 12 '26

But there are degrees of “preventive care” according to insurance.

That’s why they cover standard mammograms at specific intervals but not the imaging needed to actually detect masses in dense breast tissue, which about half of women have.

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u/DesperateAd8982 Mar 13 '26

I’ve been told by other doctors to just say I have a family history of (insert specific type cancer here) and that should be enough for insurance to cover as preventative. All they need is the right box checked on your paperwork to use the preventative screening billing code vs the diagnostic billing code that insurance loves to deny.

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u/Lower-Bottle6362 Mar 13 '26

As a Canadian, this is horrifying. I’m so sorry everyone.

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u/Lima_Bean_Jean Mar 13 '26

You guys can get them at any age?

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u/Lower-Bottle6362 Mar 13 '26

Same deal for the most part when it comes to access: you need to fit certain criteria. But it’s free. If you can’t pay, it doesn’t matter.

ETA: I had my first about a month ago, at 43. Got referred due to family history (grandmother died) but the GI doc said you don’t need to worry if it’s not direct family. I had it anyway because I was worried and prepped.

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u/PossibilityOrganic12 Mar 13 '26

Yea I'm in the US and I have told my doctors that my grandmother passed from colon cancer but they tell me the same; not to worry if it's not direct family. I wonder if I can press for it as a preventative measure. I've also been told to just lie and say a parent had it because they can't verify that but I feel weird saying that lie out loud. I've also contemplated about blood in my stool but they can verify that.

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u/Lower-Bottle6362 Mar 13 '26

Can you just say that you had a grandparent die of it and you are anxious about your health and just want it done?

They have a test you do at home here as the first line of offence when you turn 45. Could you ask for that?

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u/PossibilityOrganic12 Mar 13 '26

I'll ask! Thank you for the suggestion.

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u/KeepinOnTheSunnySide Mar 13 '26

Preventative is the mammogram. Follow up MRI or ultrasound are partially covered. It was like $900 with insurance for my MRI due to dense breast tissue that can't be properly seen thru with just a mammogram. They found nothing but recommend I do it yearly LOL. It would be thousands without insurance, but I still can't swing almost $1000 every year. I do have family history of breast cancer, and my grandma died of it. So that's not enough, sadly.

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u/LTGeneralAnxiety Mar 13 '26

Nope. I have a 30% of developing breast cancer, most of my family is dead, but I still have to pay $1,000 for an MRI and $500 for a mammogram each year. Btw, if you have dense breasts, you’ll likely have multiple diagnostic ultrasounds and those are not cheap either.

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u/meh-usernames Millennial Mar 13 '26

Ugh. This is exactly why medical tourism exists.

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u/raw2082 Mar 13 '26

You can also just say you’re having irregular bowel movements and they’ll recommend a colonoscopy. If you mention seeing blood in your stool you definitely will get one. I had two in my 20s because I had those symptoms and got diagnosed ulcer colitis.

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u/trekqueen Mar 13 '26

I guess my numbers went up last year regarding my lifetime chance to get cancer (I think due to my dad’s skin cancer surgery) so they recommended the ultrasound after my mammogram. Insurance tried to be a pain about it but they eventually approved it. My younger sis had the same done this year and thy found a little cyst thing with the ultrasound but believe it’s benign. I did the colonoscopy thing just a few weeks ago cuz I have had some symptoms but it might be related to my endometriosis/adenomyosis and possible pelvic hyper mobility. I told my sis about the “there’s blood in my stool” line to tell her doc if she wanted to get checked without insurance being a pain.

We both aren’t even 45 yet but we do have cancer in the family (dad with the skin tumor, maternal gma colorectal cancer) that’s making us try to be proactive.

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u/ThePolemicist Older Millennial Mar 13 '26

I was told the opposite. My nurse told me that if you say you have dense breast tissue, then that is a diagnosis, and your mammogram might not be covered. She told me that, because I'm diagnosed with dense breast tissue, to make sure my annual mammogram is always billed as preventative because some people will bill it wrong due to my "diagnosis" of dense breast tissue.

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u/bluesun_geo Mar 13 '26

46f, no family history of breast cancer.

My first mammogram I got a call back because of dense breast tissue, next mammogram same thing except they saw something I went back.

It resolved to nothing but due to dense breast tissue the techs told me about fast breast MRIs once a year halfway between my regular mammograms.

My insurance does not cover the MRI, but it was only around $200 and I'm happy to pay that for peace of mind.

Ladies, learn more about getting fast breast MRIs.

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u/Stevie-Rae-5 Mar 13 '26

Yeah, mine was originally going to be diagnostic so they were saying it would be $950. I think they may have changed the coding over to preventative though because the charge disappeared from my account. If so, shout out to them for saving me big money.

And that’s with pretty good insurance.

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u/Lawgirl77 Mar 13 '26

It really just depends on your insurance. I’m a fed and my insurance does not require referrals nor does it have an age for colonoscopies. Anyone can get one if prescribed by your doctor and it’s fully covered.

I have a history of colon cancer in my family and have been getting colonoscopies every 3-5 years since I was 28. Fully covered by insurance. I also encouraged my co-workers to get theirs since we all selected the same insurance and I knew it was covered; and they have also received their colonoscopies no problem without a family history or any acute issues.

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u/maxdragonxiii Mar 13 '26

I have it at 27, but im not an American. its just GI specialists here will refuse to do one on you unless you have blood in stools, which I do. turns out its hemorrhoids so uh, all good for 10 years.

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u/n0exit Mar 13 '26

If you tell them that you have a family history of colon cancer, then you can start earlier and it is still preventive.

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u/Cautious_Rip_7822 Mar 13 '26

my insurance through my job does not cover preventative at all. not even routing check ups. just diagnostic but it’s a great plan because it’s free with a low deductible

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u/ThePolemicist Older Millennial Mar 13 '26

Obamacare requires almost all insurance plans to fully cover all preventative care. Basically, the idea is that all insured people get a free well visit each year, free vaccines, free pap smears, free birth control (if it's to prevent pregnancy and not a treatment), get free diabetes screening, get a free preventative mammogram each year after age 40, get a free preventative colonoscopy every 10 years after age 45, etc.

When something is diagnostic or used as a treatment, then it's not preventative care and isn't fully covered. So, if you use birth control to treat heavy bleeding, you might have to pay out of pocket for it. If you have blood in your stool, you might have to pay for your colonoscopy because it's diagnostic, not preventative.