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Does Medicare Cover Colonoscopies?

Beneficiaries enrolled in Original Medicare (Part A and Part B) may receive coverage of different types of colorectal cancer screening tests. These tests are used to detect precancerous growths or cancer in its earliest stages when it is the most treatable. Medicare Part B, also known as medical insurance, covers several types of screening tests, including:

  • Colonoscopies: Medicare covers colonoscopies once every 24 months if you are at high risk for colorectal cancer. It covers colonoscopies once every 120 months if you are not at high risk for colon cancer. If your doctor accepts assignment, you pay nothing for this screening.
  • Barium Enemas: This test may be used instead of a colonoscopy. Medicare covers it once every 48 months if you are over 50 years old, or once every 24 months if you are at high risk for colon cancer. You may be responsible for a 20% Part B coinsurance amount and, if you find yourself in a hospital outpatient setting, you may also be responsible for a copayment.

  • Fecal Occult Blood Test: Medicare covers this test once every 12 months if you are 50 years or older. You pay nothing for the test itself but may be responsible for paying a coinsurance amount for the doctor's visit.

  • Flexible Sigmoidoscopy: Medicare covers with test once every 48 months, or 120 months after a previous colonoscopy. You pay nothing for the test itself, but you may be responsible for paying a coinsurance or copayment for the doctor's visit.

If you are enrolled in a Medicare Advantage plan, you receive the same benefits as you would in Original Medicare, so the coverage mentioned above also apply.

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