Preventive screening coverage depends on the type of insurance, whether the service meets preventive-screening criteria, the provider/facility network, and how the claim is coded. Confirm your own benefits before the procedure whenever possible.
Medicare covers screening colonoscopy. There is no minimum age requirement. Frequency is generally every 120 months for people not at high risk, every 24 months for people at high risk, or 48 months after certain prior sigmoidoscopy screening.
For eligible beneficiaries age 45 or older, Medicare covers fecal occult blood screening once every 12 months.
For eligible average-risk, asymptomatic beneficiaries ages 45–85, Medicare covers multi-target stool DNA testing every 3 years.
For eligible average-risk, asymptomatic beneficiaries ages 45–85, Medicare covers qualifying blood-based biomarker screening once every 3 years if available and coverage criteria are met.
For eligible beneficiaries age 45 or older, Medicare covers CT colonography at intervals that depend on colorectal cancer risk and prior screening.
Medicare covers screening sigmoidoscopy for eligible beneficiaries age 45 or older; frequency depends on risk and prior colorectal screening.
Medicare states that when a covered non-invasive stool-based or blood-based biomarker screening test is positive, Part B covers the follow-up colonoscopy as a screening test.
Medicare says you pay nothing for a covered screening colonoscopy when the provider accepts assignment, including qualifying follow-up colonoscopy after a positive covered non-invasive test.
Medicare currently states that if a polyp or other tissue is removed during the colonoscopy, 15% coinsurance can apply to provider services and, in certain outpatient settings, facility services. The Part B deductible does not apply.
For non-grandfathered plans subject to the Affordable Care Act preventive-services rules, federal guidance says recommended preventive colorectal screening must generally be covered without cost sharing when requirements are met. Federal FAQs specifically describe integral services such as medically appropriate anesthesia, bowel-prep medication, polyp removal, pathology from a screening colonoscopy, and follow-up colonoscopy after a positive non-invasive stool test or certain visual screening tests.
Medical content reviewed against these sources on September 5, 2026. This does not replace clinician review before public launch.