Explore your options now at eHealthInsurance

Medicare Coverage of Colorectal Cancer Screenings

By on March 29th, 2012
Filed: Advice, Caregivers, Consumers, Early Retirees, Families, FAQs, Medicare, Seniors, Tips

March is National Colorectal Cancer Awareness month.

Photo via caroline_1 on Flickr

We want to remind our readers that even though the month of March is ending, you should still schedule your regular colorectal cancer screening.

Colorectal cancer is not only the third most common cancer diagnosed in both men and women, but is also the second leading cause of cancer-related deaths in the United States. More than 50,000 people die from colorectal cancer and almost three times that many people are diagnosed with the illness every year.

Deaths caused by cancer has been gradually decreasing from 2004 to 2008, says a new report from four major national cancer tracking groups. The decline in death rates may reflect against the progress made against the disease in regards to prevention, diagnosis, and treatment.

ABC News also covered the report. You can read their report here.

However, it doesn’t mean that the decline is simply up to doctors and experts; it is important for everyone to actively get regular screenings for colorectal cancer.

Screening for Colorectal Cancer

Many cases of colorectal cancers start as benign, noncancerous polyps, which then slowly develop into cancer. Colorectal cancer screenings can help find these polyps and remove them before they become more serious. Screenings can also catch cases of colorectal cancer early on, thus allowing for earlier and more effective cancer treatment.

More than 90% of colorectal cancer cases occur in individuals 50 years old and older. If all individuals that fall into this category were screened regularly, nearly 60% of deaths from this cancer could be prevented, according to the Center for Disease Control and Prevention.

Medicare Coverage of Colorectal Cancer Screenings

For Medicare beneficiaries, you do not have to worry much about the costs when it comes to colorectal cancer screenings. Medicare covers a variety of screenings for colon and rectal cancer screenings. All Medicare beneficiaries are eligible for a screening colonoscopy while all other colorectal screenings are available to Medicare beneficiaries, who are age 50 years old or older.

As stated on Medicare.gov, these screenings and the frequencies of their coverage include:

  • Fecal Occult Blood Test: Once every 12 months.
  • Flexible Sigmoidoscopy: Generally, once every 48 months, or 120 months after a previous screening colonoscopy for people not at high risk.
  • Screening Colonoscopy: Generally once every 120 months (once every 24 months if you’re at high risk), or 48 months after a previous flexible sigmoidoscopy.
  • Barium Enema: Your doctor can decide to use this test instead of a flexible sigmoidoscopy or colonoscopy. This test is covered every 24 months if you are at high risk for colorectal cancer and every 48 months if you aren’t at high risk.

In most cases, Medicare beneficiaries pay nothing out of pocket for fecal occult blood tests, flexible sigmoidoscopy, and screen colonoscopy, if your doctor accepts Medicare assignment. In the case of barium enemas, individuals on Medicare pay 20% of the Medicare-approved amount and a copayment if the procedure is done in a hospital outpatient setting. The Medicare Part B deductible does not apply.

If you are age 50 or older or you have a family history of colorectal cancer, make sure to schedule regular colorectal cancer screenings to reduce your risk and to receive early treatment, if necessary.

Getting a colorectal cancer screening could mean the difference between life and death.


About Angela Chen

Angela Chen is a contributor and editor of the eHealth Medicare Blog and the Plan Prescriber Blog.

1 Comment Add Your Comment

By submitting a comment you agree to the comment policy.