Colorectal cancer (CRC) is the second deadliest cancer in the U.S., but it’s also highly preventable. This March, learn more about CRC and take charge of your colon health.
Three things you need to know:
Early detection is key. With a 91% survival rate when caught early, getting screened for colorectal cancer could save your life.
Don't wait for symptoms like:
Blood in your stool
Unusual bowel changes
Persistent stomach pain
Unexplained weight loss
Screening saves lives: Regular screening starting at age 45 significantly reduces your risk. Several safe and effective options are available, like colonoscopies and stool-based tests.
Know your risk factors: Some people are at higher risk due to family history, certain medical conditions, or ethnicity. Talk to your doctor to understand your individual risk.
How Does Medicare Cover Colonoscopies?
Medicare covers screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There’s no minimum age requirement.
If you initially have a non-invasive stool-based screening test (fecal occult blood tests or multi-target stool DNA test) and receive a positive result, Medicare also covers a follow-up colonoscopy as a screening test.
Your costs in Original Medicare
If your doctor or other health care provider accepts assignment, you pay nothing for the screening test(s). However, if your doctor finds and removes a polyp or other tissue during the colonoscopy, you pay 15% of the Medicare-Approved Amount for your doctors' services. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15%
coinsurance amount. The Part B deductible doesn't apply.
Perfiniti Tip:
If you are enrolled in a Medicare Advantage Plan, preventive colonoscopies are a $0 copay. If the doctor codes it as a diagnostic procedure you will be charged your outpatient services copay.
Medicare Supplement Plan enrollees will have no charges for their preventive colonoscopies since the Part B deductible does not apply. Contact your agent for specific details on your plan.
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