Colonoscopy and Your Medicare Coverage


Avoiding cancer is hard sometimes when you are at high risk due to family history and this makes it hard on your bank account.  Screenings and testing in trips to the doctor’s office aren’t cheap, but they can become cheaper thanks to your Medicare coverage.  Medicare covers this test once every 24 months if you’re at high risk for colorectal cancer.

You can still get some coverage when you are not at high risk, but the appointments and treatments are not as frequent as when you are at risk.  If you aren’t at high risk for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a screening flexible sigmoidoscopy.

Starting January 1, 2011, you pay $0 for this test. There is no coinsurance, copayment, or deductible if the doctor accepts assignment.  If a screening test results in the biopsy or removal of a lesion or growth, the procedure is considered diagnostic, and you may have to pay coinsurance or a copayment; however, the Part B deductible doesn’t apply.

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