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Free Screening Colonoscopies

Download the Free Screening Colonoscopies PDF

As of Jan 1, 2011, you may now qualify for a free screening colonoscopy.

Here’s who is eligible:

Medicare Patients

If you’re a Medicare patient, you can qualify for a free screening colonoscopy if you:

  • are of the recommended screening age
  • do NOT have any symptoms of colon cancer
  • do NOT have personal history of colon polyps or colon cancer.


Note: A Medicare patient can still qualify for a free screening colonoscopy even if you have a family history of colon cancer or colon polyps.

Cost of a Screening Colonoscopy:

  • $0 annual deductible for procedure
  • $0 co-insurance for procedure

Cost of a Diagnostic Colonoscopy:

  • $0 annual deductible for procedure
  • 20% co-insurance must be paid for procedure


Private Insurance Patients

If you have private insurance and your insurance plan offers free colonoscopies, then you can qualify for a free screening colonoscopy if you:

  • are of the recommended screening age
  • do NOT have any symptoms
  • do NOT have personal history of colon polyps or colon cancer


Note: Most private insurance companies DO NOT cover the costs of a screening colonoscopy if you have a family history of colon cancer or colon polyps. You need to check your policy or call your provider to determine whether or not you are eligible for a free screening colonoscopy.

  • Cost of a Screening or Diagnostic Colonoscopy: check with your insurance provider to determine the full extent of your benefits and whether or not you are responsible for any potential out-of-pocket costs.


How Do Free Screening Colonoscopies Work?

Medicare patients who are eligible for a free colonoscopy screening will pay no deductible, co-pay or co-insurance. Some private insurance companies are also required to offer full coverage for screening colonoscopies with no out-of-pocket costs going forward. Private insurance patients should contact their insurance company to determine their benefits. Also, both Medicare and private insurance patients may still be responsible for other services, such as anesthesia, associated with the procedure.

What is a Screening Colonoscopy?

A screening colonoscopy is a procedure performed on a patient of screening age, who has no symptoms in order to find colon polyps or cancer. General guidelines recommend that the age for screening colonoscopies begins at 50 for people at average risk. Recent studies indicate that African-Americans may need to start screening at age 45.?

Note: A screening colonoscopy is NOT a colonoscopy that is performed to explain the patient’s symptoms (i.e. blood in stools, changes in bowel movements, etc.).

Screening Colonoscopy vs. Diagnostic Colonoscopy

A colonoscopy that is performed in order to explain symptoms is called a diagnostic colonoscopy, which is not considered free by Medicare. Private insurance patients are also usually fully liable for all cost related to a scheduled diagnostic colonoscopy.

There are some cases where a scheduled screening colonoscopy can become a diagnostic colonoscopy, and in those cases, a patient is responsible for any out-of-pocket costs related to their deductible, co-insurance or co-pays for standard costs like physician and facility fees.

A screening colonoscopy becomes a diagnostic colonoscopy when a physician removes a polyp or takes a biopsy during the procedure.

Although many physicians recommend patients with a family history of polyps or colon cancer to get screened earlier than the recommended age, some private insurance companies consider a family history of colon cancer or colon polyps as a criterion for a diagnostic colonoscopy – NOT a screening colonoscopy.