Colonoscopies (screening)
Medicare covers screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There’s no minimum age requirement.
If you initially have a Medicare-covered, non-invasive stool-based colorectal cancer screening test (fecal occult blood tests or multi-target stool DNA test), or a blood-based biomarker screening test and get a positive result, Medicare also covers a follow-up colonoscopy as a screening test.
Your costs in Original Medicare
- If your health care provider accepts assignment , you pay nothing for the screening test(s), including follow-up colonoscopies you get after a positive result from a Medicare-covered blood-based biomarker test or non-invasive stool-based test.
- If your health care provider finds and removes a polyp or other tissue during the colonoscopy, you pay 15% of the Medicare-approved amount for your provider's services. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15% coinsurance . The Part B deductible doesn't apply.
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
- Other insurance you may have
- How much your doctor charges
- If your doctor accepts assignment
- The type of facility
- Where you get your test, item, or service
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.
What it is
Colonoscopy screening tests check for precancerous polyps (growths in the colon), cancer, and other diseases inside the rectum and colon.