Colonoscopy is a key cancer screening, and Medicare covers it. Here's what's free and one cost to watch for.
How does Medicare cover screening colonoscopies?
Medicare covers screening colonoscopies to check for colorectal cancer before symptoms appear, and the screening itself costs you nothing when your provider accepts Medicare assignment, with no Part B deductible. How often you're covered depends on your risk: for people at high risk, Medicare covers a screening colonoscopy once every 24 months; for those not at high risk, once every 120 months (or 48 months after a flexible sigmoidoscopy). Medicare also covers other colorectal screenings, including stool-based tests, and a follow-up colonoscopy after a positive non-invasive screening test. This is one of Medicare's most valuable free preventive benefits. Call 1-800-MEDIGAP at 1-800-633-4427.
The polyp removal cost to know about
There's one situation where a screening colonoscopy can generate a bill. If your doctor finds and removes a polyp or takes a tissue sample during the screening, the procedure may be reclassified from purely preventive to diagnostic. In that case, you pay a reduced coinsurance, currently 15% of the Medicare-approved amount, though the Part B deductible still doesn't apply for this screening-related service. This is a common surprise for patients. A Medigap plan can cover that coinsurance. Knowing this in advance helps you avoid confusion about the bill. For free help understanding your colonoscopy coverage and costs, call 1-800-MEDIGAP at 1-800-633-4427.