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Does Medicare Cover Colonoscopy For Seniors?

Looking for How Much Does Medicare Pay for Cataract Surgery? This Review Reveals the answer.

Medicare is health insurance for people 65 or older. You’re first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). 

It is important to understand what Medicare is willing to cover, so we don’t have a big bill afterward.

Colonoscopy: Effective… Safe… Affordable…

What Is A Colonoscopy?

A colonoscopy (koe-lun-OS-kuh-pee) is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum.

During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.

If necessary, polyps or other types of abnormal tissue can be removed through the scope during a colonoscopy. Tissue samples (biopsies) can be taken during a colonoscopy as well.

Medicare’s Coverge Of 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 for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There’s no minimum age requirement.Your costs in Original Medicare

You pay nothing for this 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 colonoscopy, you may pay 20% of the  Medicare-Approved Amount of your doctor’s services and a  copayment in a hospital setting. The Part B  deductible doesn’t apply.

Note:

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Note:

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

For more information Colonoscopy Screening Coverage (medicare.gov)

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