Yes, Medicare covers a colonoscopy, and for routine colorectal cancer screening you pay nothing when your provider accepts assignment. Coverage isn't the hard part. The details are: which test you get, the age you become eligible, how often Medicare will pay for it, and what happens to the price if your doctor removes a polyp while you're under. Those rules aren't the same for every screening.

In This Guide

Does Medicare Cover a Colonoscopy?

Short answer: yes. Medicare Part B treats colorectal cancer screening as a preventive service, and the screening colonoscopy is the centerpiece of that benefit. When your provider accepts assignment and the exam turns up nothing that needs removing, a screening colonoscopy costs you $0, with no deductible and no coinsurance. If your doctor does find and remove a polyp while you're in there, you pick up a share, and the cost section below has the numbers.

"Accepts assignment" just means the provider agrees to the Medicare-approved amount as full payment. Most do, but it's a fair question to ask when you schedule, because that agreement is what keeps the screening free.

Unlike some other screenings, a screening colonoscopy has no minimum age under Medicare. If you're on Medicare and your doctor recommends one, the age rule isn't what stands in the way.

Which Tests Medicare Covers: Colonoscopy, Stool Test, and Sigmoidoscopy

Medicare doesn't cover just one colorectal test. It covers a few, and the rules for age and timing aren't identical, so it helps to see them side by side. The stool-based screening and the flexible sigmoidoscopy both start at age 45. The screening colonoscopy has no age floor, and how often it's covered depends on whether you're at high risk.

Screening test Age you become eligible How often Medicare covers it
Stool-based screening (fecal-occult blood test) 45 and up Once every 12 months
Flexible sigmoidoscopy 45 and up Once every 48 months; if you aren't at high risk and have had a screening colonoscopy, once 119 months have passed since it
Screening colonoscopy No minimum age Once every 24, 48, or 120 months, depending on your risk; if you aren't at high risk and have had a screening flexible sigmoidoscopy, only after at least 47 months have passed since it

For the screening colonoscopy, the interval is the piece people ask about most. If you're at high risk for colorectal cancer, Medicare covers one every 24 months. If you're not, it's once every 120 months. "High risk" has a set definition in federal regulation, and it's broader than it sounds. You count as high risk if you have any one of these:

  • A parent, sibling, or child who has had colorectal cancer or an adenomatous polyp
  • A family history of familial adenomatous polyposis or of hereditary nonpolyposis colorectal cancer
  • A personal history of adenomatous polyps or of colorectal cancer
  • Inflammatory bowel disease, including Crohn's disease and ulcerative colitis

If one of those fits you, make sure your doctor knows, because it's what puts you on the 24-month schedule instead of the 120-month one.

So the practical takeaway is to match the test to your situation. Many people start with the once-a-year stool test at 45, while others go straight to a colonoscopy on their doctor's advice. If a Medicare-covered stool test comes back positive, the follow-up colonoscopy is covered as a screening test too, so you pay nothing for it when your provider accepts assignment. A positive home test isn't a reason to skip the colonoscopy over cost.

The same rule reaches past the fecal-occult blood test. If you have a Medicare-covered multi-target stool DNA test (Cologuard is the best-known one) or a Medicare-covered blood-based biomarker test and the result is positive, the follow-up colonoscopy is also covered as a screening test, and you pay nothing for it when your provider accepts assignment. That follow-up also isn't held to the usual 24- or 120-month spacing. Mention the positive result when you schedule so the office knows why the colonoscopy is being ordered. Whether you're eligible for the stool DNA or blood-based test itself, and how often, is a separate question from the follow-up; ask your doctor or check Medicare.gov before you order one.

What Medicare Colorectal Cancer Screening Actually Costs

For a screening colonoscopy where nothing needs to come out, when your provider accepts assignment, you pay $0. No deductible and no coinsurance. That much is exactly as good as it sounds, and it's the whole point of the preventive benefit.

What the $0 leaves out is what happens if your doctor finds something. If they find and remove a polyp or other tissue during the colonoscopy, you pay 15% of the Medicare-approved amount for their services, and in a hospital outpatient department or an ambulatory surgical center you pay the facility another 15%. The Part B deductible doesn't apply. So the same appointment can end at $0 or with a bill, and which one you get is decided while you're asleep.

That's a different situation from the other way a colonoscopy stops being free. A colonoscopy your doctor orders to investigate symptoms, rather than as routine screening, isn't the preventive test at all. Those services fall under standard Part B cost-sharing, which means you'd pay the annual Part B deductible ($283 in 2026) and then 20% of the Medicare-approved amount. The procedure is the same; the reason it was ordered sets the price. A colonoscopy that follows a positive result on a Medicare-covered stool test is not in that group: Medicare covers it as a screening, at $0 when your provider accepts assignment.

None of this is a reason to put the screening off. A polyp found and taken out during a screening is the procedure doing the job you booked it to do, and the alternative is not a cheaper colonoscopy, it's not knowing. What's worth doing is calling the office beforehand and asking two things: how the visit is being coded, and what your share would be if they do remove something. Then a bill, if one comes, is a number you already saw coming.

Frequently Asked Questions

Does Medicare cover a colonoscopy?

Yes. Medicare Part B covers a screening colonoscopy as a preventive service, and you pay $0 when your provider accepts assignment and nothing is removed during the procedure. There's no minimum age for a screening colonoscopy under Medicare.

How often does Medicare cover a colonoscopy?

For a screening colonoscopy, coverage comes once every 24, 48, or 120 months, depending on your risk. People at high risk for colorectal cancer are covered every 24 months; people not at high risk, every 120 months. High risk has a fixed definition: a parent, sibling, or child who has had colorectal cancer or an adenomatous polyp, a family history of certain inherited colorectal conditions, your own history of adenomatous polyps or colorectal cancer, or inflammatory bowel disease.

At what age does Medicare cover colorectal cancer screening?

It depends on the test. The stool-based screening and flexible sigmoidoscopy are covered starting at age 45. A screening colonoscopy has no minimum age.

Is a stool test for colon cancer covered by Medicare?

Yes. The screening fecal-occult blood test is covered once every 12 months for people 45 and older.

Does Medicare cover a colonoscopy after a positive Cologuard or other stool test?

Yes. After a positive result on a Medicare-covered stool-based test (including a multi-target stool DNA test) or a blood-based biomarker test, Part B covers the follow-up colonoscopy as a screening test, and you pay nothing when your provider accepts assignment. If the doctor removes a polyp during it, the 15% cost-sharing described below still applies.

Do I still pay $0 if they remove a polyp?

No. If your health care provider finds and removes a polyp or other tissue during the screening colonoscopy, you pay 15% of the Medicare-approved amount for their services, plus another 15% to the facility if the procedure is done in a hospital outpatient department or an ambulatory surgical center. The Part B deductible doesn't apply. The screening is still covered, and the removal is still the outcome you want.

Why did I get a bill for my colonoscopy?

Usually one of two reasons. The first is that something was removed: a polyp or other tissue taken out during the screening brings 15% coinsurance on the provider's services, and another 15% to the facility in a hospital outpatient department or surgery center, with no Part B deductible. The second is coding: if your colonoscopy was ordered to look into symptoms, it's diagnostic care rather than the free preventive screening, so standard Part B cost-sharing applies, meaning the deductible and then 20% coinsurance. Ask the provider which one your bill reflects.

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Find personalized help understanding what a colorectal cancer screening will actually cost at brevy.com.

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.

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