20Mar2018

Colon surgery costs and how to pay for them

The need for colon surgery often comes after a routine colonoscopy, a diagnostic procedure to inspect the health of a patient’s colon. Most people come through colonoscopies without the need for further procedures, but, according to The Cleveland Clinic, about 15% of women and 25% of men are found to have pre-cancerous polyps which need further attention. And some are found to have even more serious issues that can be addressed only by colon surgery, also known as colectomy or colorectal resection.

The American Medical Association (AMA) reports these conditions can lead to the need for a partial or complete removal of the colon:

  • Bleeding that can’t be controlled
  • Bowel obstructions
  • Colon cancer
  • Crohn’s disease
  • Ulcerative colitis
  • Diverticulitis

Colon surgery is a serious medical procedure to correct a serious medical issue, often one which is causing a great deal of pain or discomfort and can even be life-threatening.

Unsurprisingly, this kind of surgery can be quite expensive.

How much will you pay for colon surgery, even if you have insurance?

Typical costs for colon surgery vary depending on how the surgery is performed, according to the AMA. Laparoscopic colectomy is the lower-priced, at an average of $24,196. Traditional open colectomy averages $31,601.

Using guidance on typical coverage levels from healthcare.gov, let’s assume your annual deductible is $1,300, your co-insurance is 20% and your maximum annual out-of-pocket cost is $4,400 a year.

If this is the first medical procedure you’re having in a calendar year, at these levels of insurance, your total cost for the operation would be $4,400, your maximum out-of-pocket cost.

While $4,400 is a whole lot less than $24,000 to $32,000, coming up with the money to pay it could be difficult. And, remember, that’s just an example. It’s not uncommon for annual maximum out-of-pocket costs to be even higher.

How to pay for your colon surgery out-of-pocket costs

Plan your colon surgery costs with these 3 steps:

  1. Determine exactly what your out-of-pocket cost will be. Your insurance provider or your employer’s Human Resources department can help plan out what the final cost will be. Don’t wait for the bills to arrive: Know in advance what your share of the cost will be.
  2. Identify how you will pay that bill. Do you have enough cash on hand? Can a family member help out with a loan? Should you max out your credit cards? Or might a personal loan make sense for you? If so, see below how LendingPoint could be the right answer for your needs.
  3. Move as quickly as you can to get your payment plan in place. Recent changes in rules that affect how your credit score is computed provide some short-term relief from negative effects caused by medical debt collection. Still, this additional debt will undoubtedly put pressures on your ability to meet other financial obligations. The last thing you want to do is start missing payments and do damage to your credit rating.

Why are out-of-pocket costs rising overall?

In 2017, more people have health insurance than did in previous years. But the costs for that coverage continue to rise. The cost of healthcare for a typical American family of four covered by an average employer-sponsored preferred provider organization (PPO) plan is now $26,944 according to figures released in the 2017 Milliman Medical Index. 

In addition to premiums, many plans also have deductibles — an amount you will pay first before much of the insurance benefit kicks in — and maximum out-of-pocket expenses — a higher amount that is the most you will pay for healthcare in any given year. In recent years, while premium cost increases have slowed, deductibles and maximum out-of-pocket costs have risen steadily, according to The Kaiser Family Foundation (KFF).

KFF says the cost of healthcare is causing difficulty with the personal finances of people across the United States, even those who have health insurance. “Overall, about a quarter (26 percent) of U.S. adults ages 18-64 say they or someone in their household had problems paying or an inability to pay medical bills in the past 12 months. People from all walks of life can and do experience difficulty paying medical bills.”

66% of those bills come from a one-time medical event, according to KFF. To pay for those bills, 77% of insured households with high medical bills postpone vacations or major purchases, 63% use all or part of their savings and 31% tap their retirement accounts.

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