I have a family history of colon cancer. Will Medicare cover more frequent colonoscopies for someone in my situation?

Question

Timothy Brown · Accepted Answer

If someone is deemed to be at high risk for colon cancer, Medicare will cover frequent colonoscopies every 2 years. Your doctor or other health care provider may recommend you get services more often than Medicare covers. An additional plan such as a Medicare Supplement or a Medicare Advantage can provide such additional coverage.

Answered by Timothy Brown on April 14, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Larry Dalton · Answer

Yes, under Medicare A & B, you may find that Medicare will cover your screening potentially every two years, under a doctor's order. Preventive care testing is offered as a separate rider with your Medigap programs, with some insurance carriers. These additional rider programs generally cover one hundred percent of the cost if classified as preventive care screening.

Answered by Larry Dalton on April 5, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Mark Maliwauki · Answer

Yes. Colonoscopies are preventative and therefore covered at 100%. 

You could always check on Medicare.gov as a back up to confirm.

Cassandra Mancuso · Answer

Medicare will cover a colonoscopy every 24 months. You’ll need to check with your medigap plan or advantage plan to see how many more you can get.

Steven Bleicher · Answer

Yes, the rule is that you are entitled to a colonoscopy for free every ten years. However, with a familial incidence of colon cancer, it can be sped up to every five years or even sooner. This would depend upon your own state’s laws.

Answered by Steven Bleicher on June 18, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Satoshi Aoki · Answer

Yes.

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.

https://www.medicare.gov/coverage/colonoscopies

Gary Henderson · Answer

Yes, Original Medicare typically covers colonoscopies needed for colorectal cancer, including surveillance and follow-up procedures. Medicare Part B covers colonoscopies as preventive care. For those at high risk for colorectal cancer, Medicare covers colonoscopies every 24 months. If you've had colon cancer, Medicare will cover a colonoscopy one year after treatment and then every three years.

Answered by Gary Henderson on April 19, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Andrew Kramer · Answer

Yes, your gastroenterologist will determine the frequency of colonoscopies that will be required for you. Medicare will cover that with either co-insurance, or a co-pay, depending on whether you stay on original Medicare, or choose an Advantage plan. All Advantage plans, by law, cover what Medicare covers.

Answered by Andrew Kramer on May 28, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Linda Davies · Answer

Yes, Medicare Part B covers a colonoscopy every 2 years (24 months) for individuals at high risk of colorectal cancer, such as those with a family history of the disease, inflammatory bowel disease, or polyps.

Answered by Linda Davies on May 26, 2025

Broker Licensed in IL

Answered by Linda Davies Medicare Insurance Agent

David Christian · Answer

If you have a family history of colon cancer, Medicare may cover more frequent colonoscopies, typically every 2 years, as you are considered at high risk.

Charles Borg · Answer

Yes. If you have a special situation Medicare usually adjusts for it. It is generally more flexible than a HMO plan.

Robert Remin · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/medicare-colonoscopy-coverage-family-history#robert-remin

George Francis · Answer

Medicare (Parts A, B and C) does cover colonoscopy cost related to inpatient care and outpatient care. Additionally, Medigap also provides some measure of cost coverage.

Bobby Coates · Answer

Medicare will typically cover a colonoscopy once every ten years for average at risk individuals. Individuals at a high risk (such as individuals with family history) may have a colonoscopy every 2 years. And of course Medicare will cover a colonoscopy for diagnostic purposes when conditions present.

Answered by Bobby Coates on May 15, 2025

Agent Licensed in TX, AL, AZ & 21 other states

Answered by Bobby Coates Medicare Insurance Agent

Samuel Deter · Answer

Medicare will cover a colonoscopy every 24 months. You’ll need to check with your medigap plan or advantage plan to see how many more you can get.

Answered by Cassandra Mancuso on April 28, 2025

Agent Licensed in ME & NH

Answered by Cassandra Mancuso Medicare Insurance Agent

Denise Waite · Answer

colonoscopies are covered by Medicare, but you will have to pay the co insurance cost for an coloscopies over the routing annual exam.

I have a family history of colon cancer. Will Medicare cover more frequent colonoscopies for someone in my situation?

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