Paying for Colorectal Screening Tests

Nationally, insurance coverage of colorectal cancer screening tests is now required by the Affordable Care Act, but this doesn't apply to health plans that were in place before the law was passed. These plans are covered by state laws, which can vary, and by other federal laws. 

Many of the screening tests for colorectal cancer are covered by private health insurance plans. In fact, many states now have laws requiring insurers to cover colorectal cancer screening tests. Check with your insurance provider about the tests covered by your plan and within your state.

For those with Medicare, several tests are covered after the age of 50. These tests are typically covered if you have an average risk of getting colorectal cancer:

• Fecal occult blood test or fecal immunochemical test every year

• Flexible sigmoidoscopy every four years

• Colonoscopy every 10 years

• Barium enema with air contrast every four years if your doctor thinks it’s a better test for you than a flexible sigmoidoscopy or colonoscopy

If you have a high risk of getting colorectal cancer, Medicare will cover these tests:

• Colonoscopy every two years (regardless of age) 

• Flexible sigmoidoscopy every four years

• Barium enema with air contrast every two years if your doctor thinks it’s a better test for you than a colonoscopy