If you have Medicare in Georgia, your major cancer screenings cost you $0 (no deductible, no coinsurance, no copay) as long as the provider accepts assignment. That covers screening mammograms, screening colonoscopy and flexible sigmoidoscopy, cervical (Pap) screening, the prostate PSA blood test, and low-dose CT lung screening for people who qualify.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
The catch is not the screening itself; it is what happens next. When a screening turns up something and becomes diagnostic (a polyp removed during a colonoscopy, a follow-up diagnostic mammogram, a biopsy), cost-sharing can kick in. This guide is for the Georgia Medicare beneficiary deciding which screenings they can get at no cost, and what the exceptions are.
Brevy is an eldercare company helping families navigate Medicare, Medicaid, and senior-care decisions. This is education, not medical advice. For personalized screening recommendations, consult your doctor. For coverage questions, call 1-800-MEDICARE (1-800-633-4227).
Why Georgia Medicare cancer screenings matter
Medicare covers the major cancer screenings at $0 for a reason: cost is one of the most documented barriers to using preventive care, and the screenings that work (colorectal, breast, cervical, and lung) either catch cancer earlier, when treatment works better, or catch precancerous lesions before they become cancer. Colorectal screening in particular can prevent cancer outright, because polyps found during a colonoscopy can be removed on the spot.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
For most Georgians, the practical question is not whether these screenings are covered but which ones apply to them, when, and where the $0 stops.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services The sections below walk through each screening (who qualifies, how often, and what it costs), grounded in current Medicare rules.
Colorectal cancer screening
Medicare Part B covers screening colonoscopy and flexible sigmoidoscopy at $0 when the provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services The colonoscopy is the most complete option and the only screening that can both find and prevent cancer, because polyps can be removed during the same procedure.
The most common surprise bill is the polyp exception: if a polyp or tissue is removed, the screening becomes diagnostic and you owe 15% coinsurance on the Medicare-approved amount in 2026 (phasing down to $0 by 2030), with the Part B deductible waived; a Georgia dual-eligible in the QMB group cannot be billed that coinsurance at all.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services,Centers for Medicare & Medicaid Services. (n.d.). Mln7936176 prohibition billing qualified medicare beneficiaries. cms.gov. Retrieved Jun 26, 2026, from https://www.cms.gov/files/document/mln7936176-prohibition-billing-qualified-medicare-beneficiaries.pdf Test choices and schedules, the polyp phase-down, and worked Georgia examples live in our dedicated Medicare colorectal cancer screening in Georgia guide.
Screening mammography
Medicare Part B covers mammography under Social Security Act §1861(jj) and 42 CFR 410.34. A woman age 40 or older is covered for one screening mammogram every 12 months (payment is allowed after at least 11 months have passed since the last one), and a woman ages 35-39 is covered for one baseline screening mammogram once in her lifetime. Baseline and screening mammograms cost $0 when the provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms
When mammography is not $0
A diagnostic mammogram (furnished to a person with signs or symptoms of breast disease, a personal history of breast cancer, or a history of biopsy-proven benign breast disease) is not a $0 preventive service. After you meet the annual Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount, and a diagnostic mammogram may be furnished more than once a year when medically necessary.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms So if a screening mammogram turns up an abnormality, the follow-up imaging and any biopsy carry cost-sharing.
3D mammography (tomosynthesis)
Digital breast tomosynthesis (3D mammography) has been covered by Medicare for dates of service on or after January 1, 2015. Screening DBT (HCPCS 77063) is billed with the screening code G0202; diagnostic DBT (HCPCS G0279) is billed with the diagnostic code G0204 or G0206. DBT follows the cost-sharing of the underlying study: $0 for screening, 20% after the deductible for diagnostic.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms
Worked example: Patricia, age 72, Macon
Patricia has Original Medicare with a Medigap Plan G and has had annual screening mammograms for years. Her latest screening mammogram (billed as screening) is $0.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms The radiologist flags an abnormality and recommends diagnostic imaging and a biopsy. Those services convert to diagnostic billing with 20% coinsurance after the Part B deductible.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms Her Medigap Plan G covers the coinsurance, so her out-of-pocket cost is $0. The habit of annual screening is what caught the finding early.
Cervical cancer screening (Pap test)
Medicare Part B covers cervical and vaginal cancer screening, including the Pap test, at $0 when the provider accepts assignment. The Pap test is covered once every 24 months for average-risk women, or once every 12 months for women at high risk.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Many women reach Medicare age with a long history of normal results, and clinical guidelines often support stopping cervical screening after adequate prior negative screening. Medicare does not impose an upper age limit on Pap coverage, so the decision to continue is one to make with your provider based on your history.
Prostate cancer screening
Medicare covers two prostate cancer screening tests for men who have attained age 50 (coverage is not available at age 50 or younger), each once every 12 months: the PSA blood test and the screening digital rectal exam (DRE). The two tests have different cost-sharing.Centers for Medicare & Medicaid Services. (n.d.). Prostate cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/prostate-cancer-screenings
The PSA is $0, the DRE is not
The PSA blood test costs $0 when the provider accepts assignment. The screening digital rectal exam is not a $0 preventive service: after you meet the annual Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for the DRE and the doctor's related services. The statutory basis is Social Security Act §1861(oo) (42 U.S.C. 1395x(oo)) and 42 CFR 410.39.Centers for Medicare & Medicaid Services. (n.d.). Prostate cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/prostate-cancer-screenings
This is a common point of confusion, and it is worth confirming with your provider which test is being ordered before your visit.
Whether to screen at all
Prostate screening is a genuine decision, not an automatic one. The U.S. Preventive Services Task Force (USPSTF) gives PSA-based screening a Grade C recommendation for men aged 55 to 69 (an individual decision after discussing benefits and harms with a clinician) and a Grade D recommendation (recommends against) for men 70 and older.Centers for Medicare & Medicaid Services. (n.d.). Prostate cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/prostate-cancer-screenings Medicare covers the PSA regardless, but the clinical guidance is to talk it through with your doctor.
Lung cancer screening with low-dose CT
Medicare Part B covers annual lung cancer screening with low-dose CT (LDCT) under National Coverage Determination (NCD) 210.14. You qualify only if you meet all of these: age 50-77; asymptomatic; a tobacco history of at least 20 pack-years (an average of one pack a day for 20 years); a current smoker or someone who quit within the last 15 years; and an order from your provider.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
The required counseling visit
Before your first screening, you must have a counseling and shared decision-making (CSDM) visit, using decision aids that cover the benefits and harms of screening, follow-up testing, over-diagnosis, false-positive rates, and radiation exposure. Both the CSDM visit and the LDCT are $0 when the provider accepts assignment, because lung screening is covered as an Affordable Care Act §4104 additional preventive service. Skipping the CSDM visit is the most common reason a lung screening runs into billing trouble.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
A coverage gap to know about
Medicare and USPSTF do not line up perfectly on age. USPSTF recommends annual LDCT screening for adults 50 to 80, but Medicare's NCD 210.14 covers it only through age 77, so adults 78 to 80 meet the USPSTF recommendation yet fall outside Medicare's coverage age band.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Worked example: Frank, age 62, Tifton
Frank has Original Medicare. He smoked one pack a day for 30 years and quit 14 years ago (inside the 15-year window) and has no symptoms, so he meets all the criteria.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings His doctor documents the shared-decision-making counseling visit ($0) and orders the LDCT ($0).Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings If a future scan turns up a suspicious finding, the follow-up diagnostic CT and biopsy convert to diagnostic billing with cost-sharing, but the screening itself stays free.
The Welcome to Medicare visit and the Annual Wellness Visit
Cancer screenings are usually ordered during routine primary care, and two Medicare visits anchor that process. Both are $0 with the Part B deductible waived, and neither is a head-to-toe physical exam.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
The one-time Welcome to Medicare preventive visit (the Initial Preventive Physical Examination) is available in your first 12 months of Part B and includes education about the screenings you're due for. After that, the yearly Wellness visit (the Annual Wellness Visit) is available once every 12 months and is where your provider reviews your history and orders the cancer screenings you need.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services Skipping the Wellness visit is one of the easiest ways to miss screenings, so it is worth scheduling.
What "$0 cost-sharing" does and does not cover
The $0 applies to the screening test itself, delivered to someone without symptoms, when the provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services It does not carry over to what comes after an abnormal result:
- Diagnostic follow-up. A diagnostic mammogram, ultrasound, or biopsy after an abnormal screening carries 20% coinsurance after the Part B deductible ($283 in 2026).Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/mammograms A polyp removed during a screening colonoscopy triggers the 15% coinsurance described above (deductible waived).Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
- Specialist consultations. A referral to a specialist after an abnormal screening is a standard service with the usual 20% coinsurance after the deductible.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Treatment of diagnosed cancer. Once cancer is diagnosed, the $0 screening framework ends. Outpatient chemotherapy and radiation are covered under Part B at 20% after the $283 deductible; inpatient care runs through the Part A deductible ($1,736 per benefit period in 2026); and the Part D out-of-pocket cap on covered drugs is $2,100 in 2026.Centers for Medicare & Medicaid Services. (n.d.). Chemotherapy Medical Coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/chemotherapy
Cancer screening and Medicare Advantage in Georgia
Georgia is a high-Medicare-Advantage state: as of March 2026, CMS counted 2,016,427 people with Medicare in Georgia, and 1,132,147 of them (more than half) were enrolled in Medicare Advantage and other health plans.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf Every Medicare-eligible Georgian has access to at least one $0-premium plan for 2026.Centers for Medicare & Medicaid Services. (2026). 2026 ma part d landscape state state fact sheet. cms.gov. Retrieved Jul 11, 2026, from https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf So how MA plans handle screening matters to most Georgians on Medicare.
Medicare Advantage plans must cover the same preventive screenings as Original Medicare, but a few practical differences apply:
- Networks. MA plans have networks; confirm the screening facility is in-network before scheduling to avoid a denial or a balance bill.
- Prior authorization and referrals. Some MA plans require prior authorization or a PCP referral for services like LDCT or colonoscopy; Original Medicare does not. Confirm with your plan.
- Out-of-pocket cap. MA plans cap your in-network out-of-pocket spending; the federal ceiling is $9,250 in-network for 2026, and many plans set a lower limit. That cap can protect you if a screening leads to diagnostic workup and treatment.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
For dual-eligible Georgians (Medicare plus full Georgia Medicaid), a Dual Eligible Special Needs Plan (D-SNP) is built for people with both coverages; D-SNPs operating in Georgia for 2026 include plans from UnitedHealthcare Community Plan and CareSource.Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). medicare.gov. Retrieved May 28, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP
Original Medicare with Medigap
Many Georgia beneficiaries pair Original Medicare with a Medigap (Medicare Supplement) policy. Medigap does not change the $0 screening benefit, but it does cover the coinsurance that hits when a screening becomes diagnostic (the 20% on a diagnostic mammogram or biopsy, or the 15% on a polypectomy), so the follow-up chain that would otherwise cost money is covered. The trade-off is the monthly Medigap premium on top of the Part B premium.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Where Georgia beneficiaries get help with Medicare cancer screenings
Georgia has strong cancer-care infrastructure. Emory Winship Cancer Institute in Atlanta is the state's NCI-designated Comprehensive Cancer Center, and major hospital systems across Atlanta, Augusta, Macon, Savannah, Columbus, and Albany offer screening and treatment. For lung screening specifically, confirm that the imaging facility runs a recognized low-dose CT screening program, since not every community imaging center is set up for it.
For women who are uninsured or underinsured and not yet on Medicare, the Georgia Breast and Cervical Cancer Program (BCCP), administered by the Georgia Department of Public Health (DPH), provides free or low-cost breast and cervical screening; check the DPH page for current eligibility and how to enroll. Once you have Medicare, the $0 screening benefit generally replaces the need for BCCP.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
For free, unbiased help understanding your Medicare coverage, including comparing plans and lowering out-of-pocket costs, GeorgiaCares, Georgia's State Health Insurance Assistance Program run through the Division of Aging Services, offers certified counselors at no cost.Georgia Division of Aging Services. (n.d.). Medicare Assistance. aging.georgia.gov. Retrieved Jun 24, 2026, from https://aging.georgia.gov/georgia-ship
Common questions
What does it cost to get a cancer screening with Medicare?
The covered cancer screenings (screening colonoscopy and flexible sigmoidoscopy, screening mammography, cervical/Pap screening, the prostate PSA blood test, and low-dose CT lung screening) are $0 when the provider accepts assignment, with no deductible or coinsurance. Costs can apply only if the screening becomes diagnostic (a polyp removed, a follow-up diagnostic mammogram, a biopsy).
Is the PSA test really $0 but the digital rectal exam is not?
Yes. The prostate PSA blood test is $0 when the provider accepts assignment. The screening digital rectal exam (DRE) is not a $0 preventive service: after you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for the DRE. Confirm with your provider which test is being ordered.
A polyp was found and removed during my screening colonoscopy. What does that cost?
The visit converts to diagnostic and you pay 15% of the Medicare-approved amount in 2026, with the Part B deductible waived. Congress set a phase-down: 15% through 2026, 10% for 2027-2029, and $0 from 2030. Medigap and many Medicare Advantage plans cover this coinsurance.
Who qualifies for lung cancer screening?
Adults age 50-77 with a tobacco history of at least 20 pack-years who currently smoke or quit within the last 15 years, are asymptomatic, and have a provider order. You must also have a counseling and shared-decision-making visit before your first screening. Both the counseling visit and the low-dose CT are $0 when the provider accepts assignment.
I have Medicare Advantage. Are cancer screenings still free?
Yes. Medicare Advantage plans must cover the same preventive screenings as Original Medicare at $0 in-network. Confirm your screening facility is in your plan's network, and check whether your plan requires prior authorization or a referral, since some do and Original Medicare does not.
I have Medicare and Georgia Medicaid. Are screenings still free?
Yes. Original Medicare covers the screenings at $0. If diagnostic follow-up would trigger cost-sharing, federal law prohibits providers from billing a Qualified Medicare Beneficiary (QMB) for Medicare Part A or Part B cost-sharing, so a QMB-eligible dual beneficiary is protected from those bills.
Learn More
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.