How Does Medicare Cover Colonoscopies?

About

Medicare 101

Current Clients

How Does Medicare Cover Colonoscopies?

Modern endoscope in hands of experienced medical worker stock photo

By Daniel Petkevich

Dec 27, 2022

Medicare offers coverage for screening colonoscopies once every 2 years

Medicare might not pay for many preventative procedures, but a colonoscopy is an exception. This screening for colon issues is critical to maintaining an awareness of your body. Medicare offers coverage for colonoscopies, but the frequency and cost may change depending on your situation.

Stay Up to Date on Medicare!

Overview of Medicare Coverage for Colonoscopies

Medicare offers coverage for screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare will cover the test once every 120 months or 48 months after a prior flexible sigmoidoscopy.

Who is Eligible for a Screening Colonoscopy Under Medicare?

Everyone is eligible for a colonoscopy screening. There are no age requirements. The key is making sure your healthcare provider accepts assignment.

What are the Costs Associated with a Colonoscopy Covered by Medicare?

If your doctor or other qualified healthcare provider accepts assignment, you won’t have to pay anything for the test. However, if your doctor finds and removes a polyp or other tissue during the colonoscopy, you will be required to pay 20% of the Medicare-approved amount for your doctor's services. In a hospital outpatient setting, you will also be responsible for 20% coinsurance.

How to Find Out if Your Doctor Accepts Assignment from Medicare

If you are unsure if your doctor accepts assignment from Medicare, you can contact your doctor’s office to find out. They should be able to provide that information for you.

Tips on Preparing for Your Colonoscopy Appointment

It’s important to prepare properly for your colonoscopy appointment. Here are some tips to help you get ready:

Schedule the procedure for a time when it won’t interfere with other activities
Read up on the preparation instructions from your doctor or healthcare provider
Discuss any medications you take, including vitamins or supplements, with your doctor
Follow the dietary instructions provided by your doctor or healthcare provider
Ask any questions you have to your healthcare provider prior to the procedure

By understanding the Medicare coverage for colonoscopies and how to prepare for it, you can make sure that you’re adequately prepared. If you still have questions or concerns about Medicare coverage for colonoscopies, you can contact your doctor or healthcare provider. They will be able to provide more information and help guide you through the process.

Conclusion

Medicare offers coverage for screening colonoscopies for those at high risk of colorectal cancer. If you are eligible, Medicare covers the cost of the test itself, with some exceptions depending on what is found during the procedure. Be sure to work closely with your doctor and hospital to understand all the costs associated with the procedure and to make sure that you are fully prepared for your colonoscopy appointment.

For more information about Medicare coverage for colonoscopies, contact your doctor or healthcare provider. They should be able to provide you with detailed information about what is covered and answer any other questions you may have. And for all your Medicare-related questions, call an expert at Fair Square Medicare today.

Stay Up to Date on Medicare!

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

888-572-6033

[email protected]

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

•

Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

How Does Medicare Cover Colonoscopies?

Medicare offers coverage for screening colonoscopies once every 2 years

Stay Up to Date on Medicare!

Overview of Medicare Coverage for Colonoscopies

Who is Eligible for a Screening Colonoscopy Under Medicare?

What are the Costs Associated with a Colonoscopy Covered by Medicare?

How to Find Out if Your Doctor Accepts Assignment from Medicare

Tips on Preparing for Your Colonoscopy Appointment

Conclusion

Stay Up to Date on Medicare!

Recommended Articles

More of our articles

Your Medicare One-Stop-Shop

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans