To find out if your plan is accepted, call 402-255-1687.
Colorectal cancer is usually found in people age 50 or older. The risk of developing the cancer increases with age. Medicare covers colorectal screening tests to help find pre-cancerous polyps (growths in the colon) so they can be removed before they turn into cancer. Treatment works best when colorectal cancer is found early.
Who is covered?
All people with Medicare age 50 and older, except there is no minimum age for having a screening colonoscopy.
How often is it covered?
- Fecal Occult Blood Test
Once every 12 months. You pay nothing for this test, but you usually have to pay 20% of the Medicare-approved amount for the doctor's visit.
- Flexible Sigmoidoscopy
Generally, once every 48 months, or for those not at high risk, 120 months after a previous screening colonoscopy.
- Screening Colonoscopy
Once every 120 months (high risk every 24 months) or 48 months after a previous flexible sigmoidoscopy.
- Barium Enema
Once every 48 months (high risk every 24 months) when used instead of sigmoidoscopy or colonoscopy.
Are you at high risk for colorectal cancer?
Risk for colorectal cancer increases with age. It's important to continue with screenings, even if you were screened before you had Medicare.
Your risk for colorectal cancer increases if any of the following are true:
- You have had colorectal cancer before, even if it has been completely removed.
- You have a close relative, such as a sister or brother, parent or child, who had colorectal polyps or colorectal cancer.
- You have a history of polyps.
- You have inflammatory bowel disease (like ulcerative colitis or Crohn's disease).
Your costs if you have Original Medicare.
You pay nothing for the fecal occult blood test. For all other tests, you pay 20% of the Medicare-approved amount with no Part B deductible. If the flexible sigmoidoscopy or colonoscopy is done in a hospital outpatient department or an ambulatory surgical center, you pay 25% of the Medicare-approved amount.
Get more information in the free guide, Understanding Medicare Benefits.
For detailed information about benefits and premiums, call your insurance payer or Senior Health Insurance Information Program (SHIIP)
Nebraska residents 1-800-234-7119
Iowa residents 1-800-351-4664
Colorectal screening is an outpatient procedure, however a doctor's referral is required.
Learn more about Colorectal Screening
