Medicare · Coverage
Does Medicare cover a colonoscopy?
Last reviewed October 29, 20265 min readBy the Goodsurance editorial team Reviewed by the Goodsurance editorial team
Medicare pays the full cost of a screening colonoscopy when your doctor accepts assignment. But many people still get a bill. The most common reason is a polyp that was removed during the test. Here is how often Medicare pays, what a polyp costs you, and how at-home tests like Cologuard fit in.
What Medicare covers
Part B covers a screening colonoscopy. A screening is a test you get when you have no symptoms, to find cancer or polyps early. Polyps are small growths in the colon that can turn into cancer.
- No minimum age. Medicare does not set one for a colonoscopy.
- Anesthesia is part of it. The drugs that put you to sleep count as part of the screening.
- A follow-up after a home test counts too. If a stool test or a blood test for colon cancer comes back positive, the colonoscopy that follows is also a screening.
This is one of many tests in the Medicare coverage library.
How often Medicare pays
- Average risk: once every 120 months (10 years).
- High risk: once every 24 months (2 years).
- After a flexible sigmoidoscopy: 48 months after that test, if you are not high risk. A flexible sigmoidoscopy looks at only the lower part of the colon.
Medicare says you are high risk if any of these is true:
- A parent, brother, sister, or child had colon cancer or a polyp of the type that can turn into cancer.
- You had that kind of polyp, or colon cancer, before.
- You have Crohn's disease or ulcerative colitis.
- Your family has a gene condition that causes colon cancer.
Medicare counts by month. If your last screening was in March 2016 and you are not high risk, your next one is covered starting in March 2026.
In short: every 10 years for most people, every 2 years if you or your family have a history of polyps or colon cancer.
The polyp cost trap
Your colonoscopy starts as a free screening. If the doctor finds a polyp and removes it, the test is still a screening, but you now share the cost.
- In 2026, you pay 15% of the Medicare-approved amount for the doctor's services.
- At a hospital outpatient department or a surgery center, you also pay that place 15%.
- The Part B deductible does not apply.
This share is going down by law. It drops to 10% from 2027 to 2029. Starting in 2030, you will pay nothing.
There is a second trap. If you have symptoms, like bleeding, the colonoscopy is a test to find out what is wrong. It is not a screening. Then the usual rules apply: 20% of the approved amount after the $283 Part B deductible (2026), plus a hospital copayment if you go to a hospital.
In short: a clean screening costs $0, a polyp removal costs you 15% in 2026, and a test for symptoms costs 20% after the deductible.
Cologuard and other tests Medicare covers
A colonoscopy is not the only choice. Medicare also pays for these tests, and you pay nothing if your provider accepts assignment.
- Cologuard (stool DNA test): once every 3 years. You must be 45 to 85, have no symptoms, and be at average risk. Medicare's coverage rule names Cologuard.
- Stool blood test (FOBT or FIT): once every 12 months if you are 45 or older. Your doctor must order it.
- Blood test for colon cancer: once every 3 years, for people 45 to 85 at average risk.
- CT colonography (virtual colonoscopy): every 60 months at average risk, or every 24 months at high risk, if you are 45 or older.
If a stool test or blood test is positive, Medicare covers a follow-up colonoscopy as a screening. Medicare counts it as part of the same screening. You pay nothing for it if your doctor accepts assignment.
How to keep your cost at $0
- Ask if your doctor accepts assignment. That means they take Medicare's approved amount as full payment.
- Check your dates. If it has been less than 10 years (or 2 years at high risk), Medicare may not pay.
- Ask what a polyp would cost you. Ask both the doctor and the facility.
- Tell your doctor about symptoms before the test, so you know if it will be billed as a screening or not.
- If you have a Medigap plan: every plan pays some or all of your 15% or 20% share.
- If you have Medicare Advantage: check your plan's Evidence of Coverage for network rules and costs.
- If you have Medicaid too: Medicaid may pay your share. Ask your state Medicaid office.
Common questions about Medicare
Quick answers, fast .
Tap any question to expand. Each links to a fuller standalone answer.
Does Medicare pay for a colonoscopy every 5 years?
Only if you are at high risk, and then it pays as often as every 2 years. High risk includes a past polyp, past colon cancer, or a parent, sibling, or child who had one. Otherwise Medicare pays once every 10 years.
Is there an age limit for a Medicare colonoscopy?
Medicare sets no minimum age for a screening colonoscopy. The at-home Cologuard test is covered from age 45 to 85.
Why did I get a bill after my free colonoscopy?
Most likely a polyp was removed. In 2026 you pay 15% of the approved amount for the doctor, and 15% to a hospital or surgery center. A test done because of symptoms also costs 20% after the deductible.
Does Medicare cover Cologuard?
Yes. Part B covers Cologuard once every 3 years if you are 45 to 85, have no symptoms, and are at average risk. You pay nothing if your provider accepts assignment.
References
- Medicare.gov, Colonoscopies (screening)How often Medicare pays and the 15% charge when a polyp is removed.
- Medicare.gov, Multi-target stool DNA tests (screening)Who qualifies for an at-home stool DNA test and how often.
- 42 CFR 410.37: Colorectal cancer screening testsThe legal rule: who is high risk, how often, and the follow-up colonoscopy.
- 42 CFR 410.152: Amounts of paymentThe polyp removal share: 15% through 2026, 10% from 2027, nothing from 2030.
- CMS, National Coverage Determination 210.3: Colorectal Cancer Screening TestsThe national rule that covers Cologuard, stool tests, and blood tests.