Colonoscopies test for colon cancer and other problems in the colon. This test can be expensive, and we get a lot of clients asking if this test is covered by Medicare. The answer is yes, and no. Let us explain.
Does Medicare Cover Colonoscopy Screenings?
Medicare covers colonoscopy screenings at no cost every 24 months for high risk patients, and 120 months for everyone else (in some cases every 48 months). This test is done at no cost to you, but if the test becomes diagnostic, takes a biopsy or removes a lesion, you will owe your 20% coinsurance, but you will not owe your Part B deductible.
Does Medigap Cover Colonoscopy Screenings?
While Original Medicare picks up 100% of the colonoscopy screening, all Medigap plans pay all or part of your Part B coinsurance if you need further diagnostic treatment.
Does Medicare Advantage Cover Colonoscopy Screenings?
Yes, Medicare Advantage plans cover colonoscopy screenings, however if you need more diagnostic treatment, you will owe additional costs. Since each Medicare Advantage covers services differently, you will want to research how each Medicare Advantage covers the potential additional costs of a colonoscopy.
Go to our Medicare list of preventive screenings page to learn what other tests and screenings are covered. For questions about Medigap or Medicare Advantage call a licensed independent Senior65 insurance agent at 800-930-7956.