Colonoscopy as the gold standard for colon screening

Certain preventive screenings are covered at 100 percent under HDHPs, and it is important that you take advantage of these privileges because they are an integral part of wellness and disease prevention. One of the most important preventive screenings is a colonoscopy, a test that can detect and prevent colon cancer. Colon cancer is the third leading cause of cancer death among men and women in the United States, and it is estimated that over 95,000 people will be diagnosed with the disease this year.

Although home stool tests can help detect cancer, colonoscopy is the gold standard for colon cancer screening because your doctor can view the entire length of the colon to evaluate the health of your digestive tract. If any polyps are discovered, your doctor can typically remove them during the procedure before they have the chance to develop into cancer.

How will I know when I should get a colonoscopy?

If you are at average risk for colon cancer, you should get your first screening colonoscopy at the age of 50. If you are African American, you should schedule your first colonoscopy at age 45. Having a family history of colon cancer or polyps or personal history of polyps also may lower the recommended age for your baseline colonoscopy, but you will need to talk to your doctor to determine your optimum age to be screened.

The difference between screening colonoscopies and diagnostic colonoscopies

There are two types of colonoscopy: screening and diagnostic. Screening colonoscopies are coded and covered differently than diagnostic colonoscopies. The amount an insurance provider will pay toward a colonoscopy depends on how the procedure is coded.

A screening colonoscopy is performed on an asymptomatic patient of screening age to examine for colon polyps or cancer. Your HDHP provider should cover screening colonoscopies as part of Affordable Care Act (ACA) preventive healthcare, but there are certain conditions that have to be met. You must choose an in-network gastroenterologist and an in-network hospital or facility such as an ambulatory surgery center (ASC). If you go out-of-network, you may be subject to cost sharing. Choosing an in-network doctor and facility can result in a difference of hundreds of dollars.

Before scheduling your screening colonoscopy, you should make a list of questions to ask your insurance provider to help determine your financial responsibility. Some of these questions should include, but are not limited to:

• I am _________ years old. Am I eligible for a screening colonoscopy under my current policy? NOTE: Most plans will offer colonoscopy benefits at 50 years of age. If you have a family history of colon cancer or polyps, you will have to provide the age of the first-degree relative at the time of diagnosis and ask for the information to be noted in your medical records.
• Is Dr. ______________ [your preferred physician] in-network and covered under my policy? What percentage of that doctor’s charges are covered?
• Is ______________ [your preferred hospital or ambulatory surgery center] in-network and covered under my policy? What percentage of the facility charges are covered?
• Will I have out-of-pocket costs for anesthesia? (some providers will waive deductibles and co-insurance for anesthesia costs, but you should ask your provider during this phone call).
• If the doctor finds that I have a colon polyp, will the pathology costs be covered?

Depending on your plan, most insurance companies pay for the actual screening procedure at 100 percent. However, there may be cost sharing for anesthesia or pathology charges. This depends entirely on your individual plan. Even if you have no personal or family history of colon cancer or polyps and this is your baseline colonoscopy, it is important to ask your provider about medical coverage if a polyp is found and needs to be removed.

A diagnostic colonoscopy is a procedure that is requested when symptoms are present or when another screening procedure comes back positive. In this case, you should expect to be responsible for the charges if you have not met your annual deductible. You should call your insurance company to inquire about coverage and out-of-pocket expenses. Ask your insurance provider the same questions listed above, but also request information about your financial responsibility for the procedure itself, as well as anesthesia and polyp removal (if required) and if you need further care.

Making informed choices with your HDHP

After you speak to your insurance provider, you should begin price comparing. Just as you would shop around before making any other large purchase, you should compare prices of doctors and facilities.  There is no standard cost for a colonoscopy, and you may find that several gastroenterologists in your area have widely varying costs. It is often more economical to have your colonoscopy performed at an ambulatory surgery center (ASC) because of their personal service, convenient access, shorter wait times and lower cost. By calling around to find low-cost, high-quality healthcare, you will be making informed decisions about how you spend your healthcare dollars.

Take the time to do some research so that you can make an informed decision. Whether you are making decisions about a health plan, doctor, facility or procedure, do your homework. A little bit of planning can make all the difference when the bill arrives.

In exchange for a higher deductible, the monthly premium is usually lower, but you pay healthcare costs out-of-pocket before your insurance company starts to pay.

HDHP vs. PPO and HMO

Traditional PPOs and HMOs are expensive for employers as well as employees. The Institute of Medicine estimates that 30 percent of health spending is waste. HDHPs are designed to reduce unnecessary healthcare spending and encourage consumers to take an active role in managing their own healthcare costs. Instead of paying high premiums for benefits you might never use, an HDHP allows you to decide how you want to spend your healthcare dollars.

Additionally, HDHPs can be combined with some form of savings option to allow you to set aside pretax dollars for out-of-pocket health care expenses. The savings options take several forms, including tax-free individual health savings accounts (HSAs) and employer-sponsored Health Reimbursement Arrangements (HRAs). The combination of an HDHP and a tax-free savings account is known as a consumer directed health plan (CDHP).

How HDHPs Save You Money

If you are in good health, like the idea of low monthly premiums, and plan to use your insurance for routine preventive screenings, an HDHP can help maximize your healthcare dollars. HDHPs encourage healthy living, routine preventive care, and comparison shopping for high-quality, low-cost medical services.

Because you are paying upfront for covered medical expenses, you will be charged a lower, negotiated rate between the healthcare provider and the insurance company. Preventive services like vaccinations, colonoscopies, mammograms and flu shots are covered at 100 percent, so there is no need to budget for these services. Since you are directing your own healthcare spending, you will likely make healthier lifestyle choices that will lower your risk for chronic conditions and expensive medical procedures.

How do HDHPs Work? Take the Time to Learn

Although HDHPs have spiked in popularity over a short period of time, there is a general lack of understanding about them. Also, many people feel uneasy about switching to an HDHP until they learn that HDHPs can offer consumers more flexibility and control over their own healthcare costs.

If your employer is offering an HDHP, take some time to familiarize yourself with the details. This healthcare plan may work differently than any of your previous plans. It will take some time to get used to paying out-of-pocket for doctor visits and prescriptions until you reach your deductible. It is important to invest the money you would have spent on higher monthly premiums in your HSA or other tax-free savings account. This requires discipline and planning, but it will soon become a habit.

Take ownership of your medical care and get informed.  Whether you selected an HDHP or the decision was made for you, see this as an opportunity to take initiative in your healthcare. You may find that the traditional PPO you have always chosen may not be the best use of your money.

Not all HDHPs are created equally, so contact your human resources department or benefits coordinator for more information about your HDHP. You may want to ask for literature or video tutorials so you can share the features of your HDHP and HSA with your spouse or partner. The more you learn about your new healthcare coverage, the more adept you will be at making cost-conscious, informed decisions about your medical care.  

Join us during Healthy Weight Week and commit to:

• Eat a variety of fresh fruits and vegetables
• Limit prepackaged and processed foods
• Cook at home instead of going out to eat
• Move your body and exercise
• Use a smaller plate to limit portion size
• Increase your fiber intake
• Find ways to eliminate stress from your day
• Accept your present weight and set realistic goals for weight loss
• Create positive relationships with people who encourage you

Incorporate these goals into your week and then work on making them into habits. It takes at least 30 days to form a new habit, so be patient with yourself. Success begins with embracing who you are.

Stanford University School of Medicine found that 63 percent of participants in a study who had a positive body image were more successful at losing and maintaining weight for a year compared to a 26 percent success rate for those who were dissatisfied with their appearance (Source: Shape). How can you work toward develop a positive body image? By realizing that fitness is not a number; it is a way of life. Avoid choosing a “perfect weight” for yourself. Instead, think of your ideal weight as a zone, or a range of weight in which you feel comfortable and beautiful. If you focus on healthy lifestyle instead of a number or a measurement, you can feel truly satisfied.

Share the message of Healthy Weight Week with a friend or family member. Maybe you can create some goals together!

Four HDHP Pitfalls Consumers Commonly Face

Pitfall #1: Not Understanding Your HDHP

You cannot take full advantage of your HDHP unless you understand its benefits and your responsibilities. HDHPs are quickly growing in popularity, but surveys reveal that many consumers do not have a grasp of how HDHPs vary from traditional healthcare coverage.

High Deductible Health Plans (HDHPs) feature monthly premiums which are lower than those of traditional health insurance plans like HMOs or PPOs. In exchange, you pay more out-of-pocket before your insurance company begins to pay. Also, to help you budget and prepare for the medical expenses you will incur throughout the year, the IRS allows you to open and contribute to a Health Savings Account (HSA).

Solution: Talk to your employer or your benefits coordinator for specific information regarding your HDHP. Call Member Services on the back of your insurance card. Explain that you have recently enrolled in an HDHP and you have some questions. For general information about HDHPs versus traditional health insurance, see our Understanding Your Insurance page.

Pitfall #2: Not Opening an HSA

HDHPs are attractive because of their lower premiums, which means you keep more of your paycheck. It is tempting to see this savings as a salary boost instead of an opportunity to invest in a Health Savings Account (HSA). Many people who are on an HDHP are unaware that HSAs are a unique benefit of an HDHP and that they can make monthly contributions to their HSA, tax-free, to fund their medical expenses. The IRS allows you to set aside $3,450 annually (pre-tax) for an individual and $6,900 (pre-tax) for a family to pay for qualified medical expenses, including your deductible. Many consumers are missing out on this benefit because they do not understand what an HSA is, or they think they do not need one. Not opening an HSA can cause other pitfalls that result from being unprepared when medical needs arise.

Solution: Call your insurance company and ask how you can apply for an HSA. If you meet the appropriate criteria, you can open an HSA and begin making tax-free contributions.

Pitfall #3: Neglecting Preventive Screenings

Many people on HDHPs are unaware that in-network preventive care is free, and they miss out on thousands of dollars of covered medical expenses.  Even though you are on a high deductible plan, you do not have to pay for every doctor visit and procedure. Screenings and preventive services such as colonoscopies, mammograms, immunizations (including the flu shot), blood pressure screenings, depression screenings and contraceptives are covered at 100 percent if you go to an in-network doctor.

Solution: Call Member Services on the back of your insurance card and get an updated list of no-cost preventive screenings and services. Before you make an appointment, verify with your insurance company that the doctor you have chosen is in-network so you do not incur a charge.

Pitfall #4: Delaying treatment to try to save money

Many people on HDHPs admit that they are spending less on healthcare, and sometimes skipping the care they need. If you are on a tight budget, you might try to avoid spending money on medical expenses. This might seem like a logical way to make ends meet, but delaying important doctor visits, treatments and procedures could be detrimental to your physical health as well as your financial security. For example, ignoring chronic back pain could result in an expensive surgery and hospitalization a year from now. Putting off several years of comprehensive eye exams could delay detection of a degenerative eye condition that can permanently affect your vision and quality of life.

Solution: When you need a procedure, plan ahead. Shop around to find lower prices, and use your insurer’s price transparency tool. Create a budget, and save toward your goal. Remember, the money that you deposit into your HSA is tax-free and can be used toward your deductible. If you need an expensive procedure that meets your deductible, you should plan other covered procedures in the same calendar year before your deductible resets.

Don’t Fear Asking Questions About Your HDHP

If you do not understand your HDHP, ask for help. Just as electronics and cars have a user’s manual, your HDHP has specific guidelines and regulations. Talk to your employer or benefits coordinator for literature and resources to help you make informed choices about your healthcare. It takes time and patience to learn how to maximize your benefits on an HDHP, but the cost savings are worth the effort. Open an HSA, take advantage of free screenings and services, and plan for necessary procedures. 

Guidelines exist for a reason, but they are not always sufficient in providing uniform results. A child could be ready for kindergarten at age 4. Some teenagers are not responsible enough to drive until they turn 17 — or later! And many adults need a colonoscopy before their fiftieth birthday.

According to a study published in JAMA in August 2017, colon cancer rates have been increasing among adults under the age of 55 since the mid-1990s. Even though colon cancer incidence is declining overall, younger people are dying of colon cancer at higher rates than in years past. Among 20 to 54-year-olds, the death rate has risen to 4.3 per 100,000 in 2014 compared to 3.9 per 100,000 in 2004.

Even so, the U.S. Preventative Services Task Force has not altered the recommended age for baseline colonoscopies for men and women who are at average risk for colon cancer. It remains at 50 years of age, unless you exhibit specific risk factors like a family history of colon cancer or a personal history of colon polyps. Unfortunately, most cases of colon cancer are not inherited and are difficult to diagnose without colonoscopy. There are also very few warning signs of colon cancer, so a younger person with developing colon cancer could be completely asymptomatic until the disease reaches an advanced stage.

Colon cancer is preventable with routine colonoscopies, but experts disagree about the age at which screenings should begin and the intervals at which they should occur. Some doctors are concerned about the invasiveness of colon screenings and believe that earlier screening would put individuals at unnecessary risk. Others assert that lowering the screening age will ultimately save lives and that the risk is well-worth the life-saving benefits of screening.

Whether the guidelines change or remain consistent, you can take action against colon cancer. Take some time to educate yourself and your family members about

• the risk factors for colon cancer
• the warning signs of colon cancer
• colon cancer screening options (colonoscopy is the most comprehensive, accurate screening)
• lifestyle changes to prevent colon cancer

Anyone can develop colon cancer, and you are never too young to be affected by the disease. If you notice any changes in your bowel habits or experience ongoing symptoms like abdominal cramping, pain, nausea, constipation, diarrhea or anemia, call your doctor. Early diagnosis means early intervention.

Body fat, especially in the abdominal area, puts pressure on the lower esophageal sphincter, the valve that separates the esophagus from the stomach. And when the valve fails to close properly, gastric acid can seep into the esophagus and can cause pain in the chest and throat. Chronic acid reflux and heartburn symptoms are known as gastroesophageal reflux disease (GERD).

One of the best ways to naturally treat heartburn is physical exercise. Even though there are not specific exercises that can completely relieve symptoms of GERD, there is a direct correlation between exercise-induced weight loss and reducing GERD. Physical activity does not have to be vigorous to burn body fat and prevent heartburn. In a study involving adults with acid reflux, those who took a post-dinner walk and delayed going to bed for at least three hours after eating had the fewest reflux symptoms overnight.

There are many other exercises you can try in addition to walking. Biking, swimming, hiking or ballroom dancing are good examples of low-impact activities that will help you achieve your desired result. You could also consider purchasing a treadmill or an elliptical machine that you can use in your home.

For the best possible results, try to adopt these exercise habits:

1. Avoid eating within one or two hours before exercising.
2. Stay hydrated throughout the day, but avoid energy drinks and sports drinks. Stick with water.
3. Only perform exercises that keep you in the upright position. Exercises that cause you to bend over could trigger reflux.
4. Find a workout partner. You are more likely to adhere to your exercise regime if you have accountability to someone.
5. Switch up your activities to keep it fun!

Now, why are you still reading? It is time to get moving and kick heartburn to the curb. Get creative with your workouts and enjoy waving goodbye to those extra pounds — and to heartburn! If you have questions about what exercises are best suited for your age group and activity level, talk to your doctor.

Purple potatoes, and other foods that are high in antioxidants like phenolic acids and anthocyanins, could lower your risk for colon cancer and other diseases like type-2 diabetes. Jairam K.P. Vanamala, a professor of food sciences at Pennsylvania State University, led a research project to put this theory to the test. The team studied two groups of pigs. One group received a normal diet and one group was fed a normal diet supplemented with purple potatoes. After 13 weeks, the pigs that ate purple potatoes experienced a reduction in pro-inflammatory proteins in the colon.

After he completed the study on the pigs, Professor Vanamala reflected on the team’s discovery: “What we are learning is that food is a double-edge sword — it may promote disease, but it may also help prevent chronic diseases, like colon cancer” (source: Medical News Today).

Professor Vanamala’s study is one of many that underscore the importance of eating a variety of fresh fruits and vegetables and lowering intake of high-fat foods like red meat. Even though most colon cancers are preventable with healthy choices and regular colonoscopies, the American Cancer Society predicts that there will be 95,520 new cases of colon cancer diagnosed in the United States this year. This statistic means that colon cancer is the third-leading cause of cancer death among men and women.

If your diet needs an overhaul, it’s not too late to start eating healthier foods. The foods that contain the most nutrition will be on the outer perimeter of the grocery store, especially in the produce section. You don’t have to limit your new diet to purple potatoes either. There are many other foods that contain phenolic acids and anthocyanins.

Good sources of phenolic acids include:

• Mangos
• Berries
• Apples
• Citrus fruits
• Plums
• Cherries
• Kiwis
• Tea and coffee
• Red wine
• Flour made from whole wheat, rice, corn or oats

Anthocyanins will often be purple or red in color. Good sources of anthocyanins include:

• Red cabbage
• Red onion
• Radishes
• Red beans
• Black currents
• Red, purple and black grapes
• Blackberries
• Red wine

The deepness of the pigment in a fruit or vegetable generally reflects its concentration of antioxidants. The darker the color, the more the benefit (source: American Journal of Clinical Nutrition).

To reduce your risk for colon cancer, make an appointment with your doctor to discuss preventative steps you can take each day. A diet that includes a variety of colorful fruits and vegetables, lean protein and whole grains will help you maintain a healthy weight, feel energized and stay colon cancer-free. It’s also important to be aware of risk factors like age, family history and ethnicity, so talk to your doctor to get a full picture of your digestive health.

Ginger has been used worldwide as a natural cure-all for everything from malaria to baldness, but it is most commonly celebrated as a remedy for digestive problems. Because of the vast range of gastrointestinal issues, researchers continue to “dig deeper” to find more uses for this spicy, fragrant root (Source: Web MD).

Scientists are especially curious about whether ginger can relieve acid reflux and symptoms of heartburn. A 2011 study found that participants who took ginger supplements showed reduced levels of inflammation within one month. This could be due to the phenolic compounds in ginger, which can ease stomach irritation. Phenols are also known to reduce gastric contractions that might allow acid from the stomach to flow up into the esophagus (Source: Healthline).

Currently, most studies on ginger are limited to its nausea-reducing effects, so there is certainly room for more research on ginger’s effectiveness against acid reflux and heartburn. However, there is no denying that cultures worldwide have been using ginger to soothe digestive conditions for generations. According to Home Remedies for Life, ginger can also help:

• Regulate the flow of juices in the GI tract to promote food absorption
• Absorb excess stomach acid
• Speed the digestion process
• Tighten the lower esophageal sphincter between the stomach and esophagus

So whether you seek relief from rheumatoid arthritis, menstrual pain, cough, respiratory problems, migraine headaches, bronchitis, tooth aches, snake bites or just common heartburn, give ginger a try!

Here is a recipe for ginger root tea that includes only four ingredients.

Ginger Root Tea

1. Peel and mince a piece of one-inch ginger root.
2. Boil 1 cup of water and add ginger pieces.
3. Boil water and ginger together for 5 minutes.
4. Remove from heat. Cover with lid and let steep for 20 minutes.
5. Strain and stir in ½ teaspoon honey and lemon juice to taste.

You can enjoy a cup of ginger root tea up to two times per day to help relieve heartburn. Remember that ginger should be used occasionally as a natural treatment for heartburn relief and should not be a permanent solution.

Chronic heartburn could be a warning sign of something more serious, so pay attention to your symptoms and call your doctor if your symptoms last more than two weeks or worsen.

Americans are just beginning to understand what Asian and European cultures have known for centuries. Consuming foods and beverages containing probiotics can prevent and treat conditions from stomach upset to urinary tract infections.

A normal, healthy gut contains 500 species of 100 trillion microorganisms. Illnesses, poor diet or antibiotic use can easily disrupt the delicately balanced gut flora, and it can take weeks or even months to re-establish that balance. Adding probiotics to your diet can help rebuild the beneficial bacteria in your colon and boost your gastrointestinal tract in many ways.

Probiotics help improve digestion and nutrient absorption.

Gastric acids begin the digestive process in the stomach, but friendly bacteria take over when food arrives in the colon. A healthy balance of bacteria ensures thorough digestion and efficient nutrient absorption.

Probiotics help regulate the elimination of waste.

One of the most common digestive complaints is bowel trouble. Everyone struggles with constipation or diarrhea at times, and probiotics can help with both types of bowel distress. Studies on infants showed that probiotics can help shorten the course of diarrhea. Conversely, probiotics can soften hard stools and enhance GI motility, making stools easier to pass.

Probiotics help ease symptoms of digestive disorders.

The GI tract is the center of the body’s immunity. Increasing beneficial bacteria can help treat conditions including indigestion, lactose intolerance and irritable bowel syndrome. Researchers are investigating whether probiotics can provide protection against infections and illnesses outside of the digestive tract such as tooth decay, skin infections, allergies and yeast infections.

If you have never tried probiotics, you may want to consider introducing them slowly into your diet. Here is a list of some of the most common sources of probiotics:

• Yogurt
• Kefir
• Sauerkraut
• Tempeh
• Kimchi
• Kombucha
• Pickles
• Miso
• Dark chocolate
• Apple cider vinegar

When shopping for a quality probiotic, look for a food or beverage that contains a minimum of 10 billion live bacteria. Pay attention to the expiration date as well. For maximum benefit, consume the product as soon as possible. The number of live bacteria will decrease as the expiration approaches. Enjoy trying something new for the sake of your digestion and — for life!