Does Medicare Cover Colonoscopy Screenings?

Yes, Medicare covers colonoscopy screenings. If you are at average risk for colorectal cancer, Medicare Part B covers a screening colonoscopy once every 120 months (10 years), or 48 months after a previous flexible sigmoidoscopy. If you are at high risk for colorectal cancer, Medicare covers a screening colonoscopy once every 24 months.

When you get a screening colonoscopy, you pay nothing for the test if your doctor or other qualified health care provider accepts assignment. However, if a polyp or other tissue is found and removed during the screening colonoscopy, the procedure becomes diagnostic. In that case, you may have to pay 15% of the Medicare-approved amount for your doctor's services, and the Part B deductible doesn't apply. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15% coinsurance.

Understanding how your coverage works depends entirely on the path you choose. Medsup vs MA is a rigged comparison; the real choice is Traditional Medicare (A+B) vs Medicare Advantage. The supplement decision comes AFTER you choose Traditional Medicare - it's a component of the Traditional path, not an alternative to Advantage.

If you choose the Traditional Medicare path, you can add a Medicare Supplement (Medigap) plan. A Medigap plan fills the gaps by law, meaning it will cover the 15% coinsurance if your screening becomes diagnostic. If you choose a Medicare Advantage plan, your costs for a diagnostic colonoscopy will depend on your specific plan's copays and network rules.

We walk you through every option so you can make the right choice for your health and your wallet. Straight answers, no surprises.