Colorectal cancer is cancer of the colon or rectum. Of cancers affecting both men and women, colorectal cancer is reported by the Centers for Disease Control and Prevention (CDC) as one of the top four types of cancers with high rates of new cancer cases reported per 100,000 people.1 This is why it’s important for men and women age 50 or older to get screened regularly.
Screenings may help find polyps or other abnormalities before they turn into cancer. Screenings may also help find cancer is in its early stage. As unpleasant as the tests may be, it’s important to follow screening guidelines even if you aren’t considered to be at high risk for getting colorectal cancer.
Medicare covers several types of colorectal cancer screening tests including screening colonoscopies.
How Medicare covers screening colonoscopies
Colonoscopy is considered the gold standard of colorectal cancer screening.2 If you’re at high risk for colorectal cancer, Medicare will cover a screening colonoscopy once every 24 months. For those not at a high risk, Medicare will cover a screening once every 120 months or 48 months after a previous flexible sigmoidoscopy.
Medicare will cover the costs of this test so long as your health care provider accepts assignment. You could face costs, such as a copayment, if a polyp or other tissue is found and removed during the procedure. (Learn more about coverage for screening colonoscopies and costs.)
Medicare may also cover other colon cancer screening tests
In addition to a colonoscopy, Medicare may cover the following tests to screen for colorectal cancer: a fecal occult blood test (FOBT), a screening barium enema, a stool DNA test and a sigmoidoscopy.
Fecal occult blood test (FOBT)
A non-invasive screening option, Medicare will cover a fecal occult blood test every year at no additional cost if you’re 50 or older. You do not pay anything for this test so long as the qualified health care provider accepts assignment. (Learn more.)
Screening barium enema
Medicare Part B covers a screening barium enema for individuals age 50 or older. If you’re at a high risk of colorectal cancer, the test is covered once every 24 months, and if the test is used in place of a flexible sigmoidoscopy or a traditional screening colonoscopy, it will be covered once every 48 months. (Learn more.)
Multi-target stool DNA test
Conveniently done at home, a multi-target stool DNA lab test is covered by Medicare once every three years if you are age 50 to 85, show no symptoms of colorectal disease, and you’re at an average risk for developing colorectal cancer. (Learn more about symptoms, risk levels and costs at Medicare.gov.)
Screening flexible sigmoidoscopy
For most people 50 or older, Medicare will cover screening flexible sigmoidoscopies once every 48 months. For people who aren’t considered a high risk, Medicare will cover a screening sigmoidoscopy 120 months after a previous screening colonoscopy.
Talk with your doctor about when to begin screening for colorectal cancer, what test might be right for you and how often you should be screened.
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