Does Medicare Cover Cologuard?

Is Cologuard covered by insurance like Medicare? Typically, Medicare Part B does pay for Cologuard tests every three years if you meet all of the following conditions:

• You show no signs or symptoms of colorectal disease
• You are 50-85 years old
• You have no personal history of colorectal cancer, inflammatory bowel disease or adenomatous polyps
• You have no family history of hereditary nonpolyposis colorectal cancer, familial adenomatous polyposis, colorectal cancers or adenomatous polyps

Typically, you pay nothing for Cologuard (if it is prescribed by a doctor who accepts Medicare assignment).

Other Colorectal Cancer Screenings

Cologuard is covered by Medicare, but it's not your only option when it comes to colorectal cancer screenings. Some other options you may have include:

• Barium enema
  This test is covered by Medicare every 48 months if you are age 50 or older and every 24 months if you are at a high risk for colorectal cancer
  
  
• Colonoscopy
  This test is covered every 24 months if you are at a high risk for colorectal cancer
  
  
• Fecal occult blood test
  This test is covered every 12 months if you're age 50 or older

Talk to your doctor to find out how much your specific test will cost with Medicare coverage.

For help covering some of your Medicare out-of-pocket costs like deductibles, coinsurance and copayments, consider enrolling in Medicare Supplement Insurance (Medigap). In most states, there are 10 standardized Medigap plans to choose from, with a range of available basic benefits.