How often Medicare covers it
| Your situation | Screening colonoscopy covered |
|---|---|
| Not at high risk | Once every 120 months, or 48 months after a previous flexible sigmoidoscopy |
| High risk for colorectal cancer | Once every 24 months |
A colonoscopy your doctor orders because of symptoms is a diagnostic test, not a screening. It is covered under Part B with the usual deductible ($283 in 2026) and 20% coinsurance.
What you pay
- Screening with nothing removed: nothing, if your provider accepts assignment.
- Polyp or tissue removed during the screening: in 2026, 15% of the Medicare-approved amount for the doctor's services, plus 15% to the facility in a hospital outpatient department or ambulatory surgical center. The Part B deductible doesn't apply.
- 2027 and later: CMS's phase-down lowers that share to 10% for 2027 through 2029 and to nothing from 2030.
Other colorectal screening options
A colonoscopy isn't the only covered screening. Medicare also covers, among others, a multi-target stool DNA test once every 3 years for people 45 to 85, at no cost with assignment. If a Medicare-covered stool-based test is positive, the follow-up colonoscopy is covered as a screening. Ask your doctor which test fits your risk.
If you live in Oregon
If you have both Medicare and the Oregon Health Plan, OHA says OHP can help pay Medicare deductibles and coinsurance, and people in the QMB program pay no Part A or Part B coinsurance. See Medicare and OHP together.
Medicare Advantage plans must cover screening colonoscopies too, and may require network providers. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. You can request a call from a licensed insurance agent with questions about plans from the companies they work with.
Related questions
Does Medicare cover annual physicals in Oregon?
Your yearly screening checklist.
Does Medicare cover prostate screening in Oregon?
PSA tests and exams.
Does Medicare cover mammograms in Oregon?
Screening and diagnostic.
Sources
- Medicare.gov — Colonoscopies
- Medicare.gov — Multi-target stool DNA tests
- CMS — MLN Matters MM12656, beneficiary coinsurance for colorectal screening with additional procedures
- Oregon Health Authority — OHP and Medicare
More questions in this guide
- Does Medicare cover acupuncture in Oregon?
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- Does Medicare cover annual physicals in Oregon?
- Does Medicare cover assisted living in Oregon?
- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
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- Does Medicare cover CPAP machines in Oregon?
- Does Medicare cover dental care in Oregon?
- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
Why would I owe anything for a screening colonoscopy?
Only if a polyp or tissue is removed. Medicare.gov says you then pay 15% of the Medicare-approved amount for the doctor's services and, in a hospital outpatient department or surgery center, 15% to the facility. Under federal law that share falls to 10% for 2027 through 2029 and to nothing from 2030.
Is a colonoscopy after a positive stool test covered as a screening?
Yes. Medicare covers a follow-up colonoscopy after a positive Medicare-covered stool-based test as a screening test, not a diagnostic one.
Is there an age limit for a screening colonoscopy?
Medicare doesn't set a minimum age for screening colonoscopy. Stool DNA tests are covered for people 45 to 85.
Does Medigap pay the polyp-removal share?
A Medigap policy that covers Part B coinsurance pays part or all of it. If you have both Medicare and the Oregon Health Plan, OHP can help pay Medicare coinsurance.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
