Does Medicare Cover Colonoscopies?
Key takeaways:
Medicare covers colonoscopies. If you have original Medicare, the frequency of covered colonoscopies depends on your risk of colorectal cancer. If you have a Medicare Advantage plan, your benefits will equal or exceed what’s offered by original Medicare.
Your out-of-pocket costs for a Medicare-covered colonoscopy depend on whether the procedure is preventive or diagnostic. Medicare covers the full cost of your screening colonoscopy. You’ll have cost sharing for a diagnostic colonoscopy.
If you have a noninvasive stool screening (blood test or DNA test) with a positive result, Medicare will cover a follow-up screening colonoscopy.
Table of contents
A colonoscopy allows a healthcare professional to examine the large intestine with a thin, flexible tube. The procedure is typically performed by a gastroenterologist or colorectal surgeon. As a preventive tool, the procedure is essential for early detection of colorectal (colon) cancer, the fourth-leading cause of cancer deaths in the U.S. If you have Medicare Part B or a Medicare Advantage plan, screening and diagnostic colonoscopies are both covered.
Does Medicare cover colonoscopies?
Yes, Medicare covers colonoscopies. But your out-of-pocket costs depend on whether your procedure is screening or diagnostic. The screening can determine whether you need more tests and treatment.
Screening vs. diagnostic colonoscopies
A screening colonoscopy is preventive care. It can identify early signs of cancer, such as abnormal growths known as polyps, in a person with no symptoms.
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A diagnostic colonoscopy investigates abnormal findings, signs, or symptoms. These include bleeding, diarrhea, and abdominal pain. During this procedure, any polyps are removed. A biopsy (sample) of the colon may be collected.
When does Medicare cover the full cost of a colonoscopy?
Medicare covers the full cost of a screening colonoscopy if a healthcare professional accepts the assignment. This means they agree to take what Medicare pays as full payment.
It’s important to use a Medicare-approved healthcare professional. If no abnormalities are found, you don’t have cost sharing for a screening colonoscopy. This means you don’t pay toward or have to meet the Part B deductible ($257 in 2025).
How often Medicare will cover a colonoscopy screening depends on your risk level:
Medicare covers a colonoscopy every 120 months for individuals at average risk. An exam is also covered 48 months after a flexible sigmoidoscopy (partial colonoscopy).
A colonoscopy is covered once every 24 months for those at high risk for colorectal cancer. This includes people with a family history of colorectal cancer, a genetic predisposition, a history of polyps, and an inflammatory bowel diagnosis, such as Crohn’s disease or ulcerative colitis.
With Medicare Advantage plans, colonoscopies are covered in full. You do not have to pay a deductible, a copay, or coinsurance. But be sure you have an in-network healthcare professional. You’ll also need to meet Medicare’s requirements for the procedure.
Get ready for your colonoscopy: Before your procedure, you’ll need to do bowel prep, which means consuming a clear liquid diet for 1 to 2 days.
How much does a colonoscopy cost? Without insurance, your procedure could cost from $1,250 to more than $4,000. A screening colonoscopy is typically less than a diagnostic colonoscopy, which includes a biopsy or excision.
Some colon polyps are more likely to be cancerous. Most colon polyps are benign, but ones that are large, bleeding, or blocking your stool could be signs of a problem.
When will Medicare not cover the full cost of a colonoscopy?
Medicare does not cover the full cost of a colonoscopy if it is classified as diagnostic. A diagnostic colonoscopy will have cost sharing on your part. But you don’t have to meet your deductible first.
With original Medicare, you’ll pay 15% coinsurance for a diagnostic colonoscopy. (Part B coinsurance is typically 20%.) You’ll also pay 15% facility coinsurance at a hospital or ambulatory surgical center.
Medicare Advantage plans meet or exceed the coverage offered by original Medicare.
What questions should you ask about a colonoscopy with Medicare?
Before scheduling your colonoscopy, ask a healthcare professional these questions. This will help you understand your Medicare coverage and potential out-of-pocket costs:
Will my colonoscopy be considered a screening or a diagnostic procedure?
Does Medicare cover all parts of my procedure, including anesthesia and facility fees?
What are my estimated out-of-pocket costs?
Will I need prior authorization if I have a Medicare Advantage plan?
Do I need any other tests or prep items for this procedure — and will Medicare cover them?
At what age does Medicare begin covering colonoscopies?
Medicare does not place a minimum or maximum age on covering a colonoscopy.
The U.S. Preventive Services Task Force recommends a screening colonoscopy every 10 years for people ages 45 to 75 who don’t have signs or symptoms of colon cancer. Selective screening is recommended for asymptomatic adults ages 76 to 85.
How much does a colonoscopy cost with Medicare?
You should have little to no out-of-pocket costs for a screening colonoscopy. Your cost sharing for diagnostic colonoscopy will vary. One factor is the type of facility where you have the procedure. Having your procedure at an ambulatory surgical center typically costs less than a hospital outpatient office.
Without insurance, the cost of a colonoscopy in the U.S. can range from $1,250 to more than $4,000.
The bottom line
Original Medicare and Medicare Advantage plans both cover colonoscopies. Screening colonoscopies are fully covered. But you should expect cost sharing for diagnostic colonoscopies, which typically include polyp removal and biopsy (tissue sample). Check with a healthcare professional to help determine your out-of-pocket costs.
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References
AARP. (2023). Does Medicare cover a colonoscopy?
Aetna. (2025). Does Medicare cover a colonoscopy?
Centers for Medicare & Medicaid Services. (2025). Medicare and you. U.S. Department of Health and Human Services.
Gastroenterology Consultants of San Antonio. (2022). Screening vs. diagnostic colonoscopy: What’s the difference?
Medicare.gov. (n.d.). Colonoscopies. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Procedure price lookup: Colonoscopy. Centers for Medicare & Medicaid Services.
Medicare Interactive. (n.d.). Colorectal cancer screenings.
U.S. Centers for Disease Control and Prevention. (2024). Colorectal cancer statistics.
U.S. Preventive Services Task Force. (2021). Colorectal cancer: Screening.
