A colonoscopy is a medical procedure that examines the large intestine for abnormalities. Its main purpose is to check for signs of cancer and other types of diseases. Experts recommend that people have their first colonoscopy at the age of 45. After that, those without any risk factors should get a colonoscopy every ten years. Individuals who are at a high risk of colon cancer may need to get a colonoscopy more often than that. If you think that it’s time to get a colonoscopy, then you may be wondering, “Does Medicare cover colonoscopy?”
Thankfully, Medicare will cover a portion of the costs of screening colonoscopies. The exact details of your coverage will depend on your individual risk for colorectal cancer. If you’re high risk, then you’ll have colonoscopy coverage available to you once every 24 months. Individuals who are at a lower risk have coverage available to them once every 120 months. When you qualify for Medicare coverage of a colonoscopy, you don’t have to pay a dime for the test if the doctors don’t find anything. If a polyp or some other type of tissue is found and removed during the colonoscopy, then you will likely need to pay 20% of the costs of the procedure.
Your coverage for colonoscopies may be expanded if you have a Medicare Advantage plan. These are offered by private insurance companies and build upon the offerings of Original Medicare. You can check directly with your provider to determine whether you qualify for additional screenings or reduced costs. Additionally, Medicare Advantage plans include all of the same coverages that are offered under Medicare Part A and Part B. So if your Medicare Advantage plan doesn’t include extra colonoscopy coverage, then plan on having the same coverage guidelines as someone who only has Original Medicare.
Maybe you need a colonoscopy but haven’t yet hit the time limit required to receive Medicare coverage for it. If so, you may still be able to have the costs of the procedure covered by a Medicare Advantage plan. Other options include paying for the service out-of-pocket yourself or waiting to have the screening done until you requalify for coverage under your Medicare plan.
Medicare covers a wide variety of screening tests in addition to colonoscopies. These include:
You can find the complete lists of preventative screening tests that are covered by Medicare at this link.
How Can Time for 65 Help?
You might still have some questions about Medicare’s coverage of colonoscopies. If so, consider reaching out to a partnered licensed agent through Time for 65. The agents are Medicare experts who can offer you more personalized guidance on your coverage for colonoscopies and many other medical services. Connecting with one is easy. You can do so either by filling out this form or giving us a call. Visit this link for more information on what does Medicare cover.