Does Medicare cover a colonoscopy?

Published by Medicare Made Clear®

Does Medicare cover a colonoscopy?

Colonoscopy is a screening test for colon and rectal cancer. During the procedure, the doctor checks for and removes any polyps. A polyp is a small growth on the inside of the colon that can turn into cancer. Removing them helps prevent cancer from developing.

Medicare covers a colonoscopy every 120 months (10 years) for most people, and once every 24 months if you have a high risk of developing colon cancer. Key risk factors include a history of inflammatory bowel disease or having had polyps removed in the past.

How much does Medicare pay for a colonoscopy?

Colonoscopy is a preventive service covered by Part B. Medicare pays all costs, including the cost of anesthesia, if the doctor or other provider who does the procedure accepts Medicare assignment. You don’t have a copay or coinsurance, and the Part B doesn’t apply.

Costs could be different if a polyp or other tissue is found and removed during your colonoscopy. In this case, the procedure is considered diagnostic instead of preventive. You may be responsible for 20 percent of the Medicare-approved amount for doctor services and possibly for facility charges as well. Your costs may be different with a Medicare Advantage plan.

Do I have to have a colonoscopy?

Colon cancer is very treatable when found early, and colonoscopy is the gold standard screening test. There are other screening tests for colon cancer that you may want to discuss with your doctor. The important thing is to get screened.

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