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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.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as eHealth Insurance Services, Inc.
    • Call eHealth's licensed insurance agents at 1-888-519-2029, TTY users 711. We are available 7 days a week from 8AM to 8PM ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.
    • Or enter your zip code where requested on this page to see quotes.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

eHealthInsurance is operated by eHealthInsurance Services, Inc., a licensed health insurance agency certified to sell Medicare products.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

Last Updated Date: 11/5/2016

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