Medicare Covers Screening to Detect Colorectal Cancer
Medicare covers a colonoscopy once every two years if you are at high risk for colorectal cancer. High-risk groups are those who have had colorectal polyps or colorectal cancer, people with a family history of colorectal cancer, or anyone with inflammatory bowel disease.
If you're not in a high-risk group, Medicare will cover a colonoscopy once every ten years, but not within four years of a flexible sigmoidoscopy. There is no minimum age requirement for Medicare to cover colonoscopy.
If you are at least 50 years of age, Medicare also covers a fecal occult blood test once a year, and a flexible sigmoidoscopy once every four years. Barium enema is also covered only if performed on its own, rather than in addition to the other tests.
A fecal occult blood test finds blood in the stool by placing a small stool sample on a chemically treated card, cloth wipe, or pad. A chemical solution is put on the sample, and blood is detected if it turns blue.
Fecal occult blood tests may check for intestinal conditions, including colorectal cancer, but not all blood in the stool is caused by cancer. It could result from eight other conditions, including the use of aspirin or nonsteroidal anti-inflammatory drugs called NSAIDs.
Sigmoidoscopy is a screening tool that refers to examination of the large intestine from the rectum. A sigmoidoscopy is not the same as a colonoscopy, though. A sigmoidoscopy only examines up to the sigmoid, or the most distal part of the colon. A colonoscopy examines the entire large bowel.
Medicare will cover these services without requiring a Part B deductible, and it will cover 100 percent of the fecal occult blood test. If you are in a Medicare private HMO or PPO plan, you may have a copay, though. For the other tests, Medicare will cover 80 percent of the costs, or 75 percent of a colonoscopy or flexible sigmoidoscopy performed in an ambulatory surgical center or hospital outpatient department.
Medicare Supplement Insurance Can Fill in the Gaps in Medicare Coverage
Medicare Supplement Insurance, or Medigap Insurance, can pay for expenses that are not covered through traditional Medicare. Medigap policies must have standardized benefits, but the costs can vary. You may be able to choose up to 12 different Medigap policies (Plans A through L) until June of this year. Then, four of the existing Medigap Plans are being dropped, and two new Medigap Plans are being added.
Each plan has a different set of benefits. The benefits of any Medigap Plan A, for instance, are the same regardless of which insurance company sells it, but the price may vary from different companies. That makes it important to compare companies and plans.
You generally need to have Medicare Part A and Part B to buy Medigap Insurance. You'll pay a monthly Part B premium, and a premium for the Medigap policy. Medigap Insurance won't cover your spouse, so you need separate policies.
By taking advantage of this Medicare coverage for screening to detect colorectal cancer, you can stop colorectal cancer before it endangers your health. Medicare Supplement Insurance can also help with any costs that Medicare does not cover.