Colonoscopies (2024)

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 Amountfor your doctors' services. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15% coinsuranceamount. The Part B deductible doesn'tapply.

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
  • If 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 if, or how much, Medicare will pay for them.

What it is

Tests to help find precancerous growths or find cancer early, when treatment is most effective.

Is my test, item, or service covered?

Colonoscopies (2024)

FAQs

Colonoscopies? ›

A colonoscopy is a procedure that lets your health care provider check the inside of your entire colon (large intestine). The procedure is done using a long, flexible tube called a colonoscope. The tube has a light and a tiny camera on one end.

At what age do you start getting colonoscopies? ›

Screening Recommendations

Regular screening, beginning at age 45, is the key to preventing colorectal cancer and finding it early.

What is a colonoscopy done for? ›

A colonoscopy (koe-lun-OS-kuh-pee) is an exam used to look for changes — such as swollen, irritated tissues, polyps or cancer — in the large intestine (colon) and rectum. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum.

Are colonoscopies no longer recommended? ›

There's no upper age limit for colon cancer screening. But most medical organizations in the United States agree that the benefits of screening decline after age 75 for most people and there's little evidence to support continuing screening after age 85. Discuss colon cancer screening with your health care provider.

Is it painful to have a colonoscopy? ›

Everyone's experience is different, but you can rest assured that the colonoscopy itself is painless. You will receive anesthesia so that you don't feel pain or remember the procedure. Most centers use medications that stop working quickly. That means you shouldn't feel any lingering side effects.

What are the signs of needing a colonoscopy? ›

A colonoscopy may be performed to find the cause of signs and symptoms including:
  • bleeding from the rectum.
  • blood in the stools.
  • pus or mucus in the stools.
  • unexplained abdominal pain.
  • changes in bowel habits such as unexplained and long-lasting diarrhoea.
  • screening and surveillance for colorectal cancer.

Do they put you to sleep for a colonoscopy? ›

Almost all colonoscopies in the United States are performed with patients under a level of sedation or anesthesia that prevents them from feeling anything. Often, patients are asleep for the entire procedure.

What is the biggest risk with a colonoscopy? ›

Possible complications
  • Bleeding. If a tissue sample is taken, you may notice some bleeding from your rectum for a day or two after the procedure. ...
  • Infection. Bacterial infections have been known to occur after a colonoscopy. ...
  • Reaction to anesthesia. ...
  • Postpolypectomy electrocoagulation syndrome.

What is the recovery time for a colonoscopy? ›

In fact, most patients feel up to returning to normal activities within 24 hours. It's highly recommended that patients take it easy with scheduled activities for the first week after to allow enough time to get back to normal, especially if your doctor found and removed polyps during the procedure.

What is the prep for a colonoscopy? ›

In general, they instruct you to: Avoid colored liquids and all solid foods for 12 to 24 hours before your test. Stop eating and drinking altogether by midnight on the day of your appointment. Take a pill or liquid laxative.

Why do people refuse colonoscopies? ›

“Most often, people express anxiety or fear about getting a colonoscopy. They've heard that the prep is difficult and are afraid the procedure will be painful.” Other reasons people may give for delaying a colonoscopy include: I don't have a family history of colon cancer so I'm not at risk.

What is the new way to do a colonoscopy? ›

Virtual colonoscopy requires the same preparation as standard colonoscopy. You must undergo laxative cleansing and a liquid diet for 24 hours prior to the scan. The procedure involves placing a small tube — compared to a 6-foot scope used in standard colonoscopy — in the rectum to inflate the colon.

Why do doctors push a colonoscopy? ›

In addition to helping doctors locate the source of LGIB, an urgent colonoscopy also can help them detect health conditions such as: colorectal cancer. polyps (precancerous growths) tumors or other abnormal growths.

Does it hurt to poop after a colonoscopy? ›

Does it hurt to poop after a colonoscopy? If a doctor removed polyps during surgery, people may experience some discomfort and a small amount blood in stools that decreases over time after a colonoscopy.

How long will I be on the toilet for colonoscopy prep? ›

Most people stop moving their bowels about 2 – 3 hours after finishing the solution. People are different and some have liquid movements until the time of the procedure. The instrument used during the colonoscopy will suction out any liquid left in the bowel. You will not have an “accident” during the procedure.

How far inside you does a colonoscopy go? ›

Colonoscopy (koh-luh-NAH-skuh-pee) lets the physician look inside your entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. The procedure is used as a tool for routine colon cancer screening and prevention in people beginning at age 45.

Should I get a colonoscopy at 35? ›

Colorectal cancer screening isn't recommended until age 45 for most people.

Do I really need a colonoscopy every 5 years? ›

Most people should get a colonoscopy at least once every 10 years after they turn 50. You may need to get one every 5 years after you turn 60 if your risk of cancer increases. Once you turn 75 (or 80, in some cases), a doctor may recommend that you no longer get colonoscopies.

Who should not get a colonoscopy? ›

Is there anyone who should not have the procedure? Colonoscopy is not recommended in pregnant patients, patients 75 years or older, patients with limited life expectancy, or in patients with severe medical problems making them high risk for sedation.

At what age should you start getting mammograms? ›

Updated: April 30, 2024.] Women who are at average risk for breast cancer should start mammogram screening at age 40 and get one every two years until age 74.

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