Colon Cancer Screening After 50: Your Options and What Medicare Covers
Colorectal cancer screening checks for signs of trouble in the colon and rectum before you have any symptoms. It is one of the most useful routine checkups, and for people with Original Medicare it can cost little or nothing. Here is what the official sources say, as of November 2026.
Who Should Be Screened
The Centers for Disease Control and Prevention (CDC) says adults aged 45 to 75 should be screened. For ages 76 to 85, the decision is made person by person, so talk with your doctor. Some people need to start earlier or be screened more often, including those with inflammatory bowel disease or a personal or family history of colorectal cancer or polyps.
The Main Types of Screening Tests
The CDC lists several options. Some are done at home and some at a medical office:
- Stool tests (FIT or gFOBT): a sample is collected at home and sent to a lab, usually every year.
- Stool DNA test (FIT-DNA): a stool sample is checked for blood and altered DNA, usually every 3 years.
- Flexible sigmoidoscopy: a doctor examines the lower part of the colon, usually every 5 years.
- Colonoscopy: a doctor examines the whole colon and can remove most polyps, usually every 10 years if your risk is not increased.
- CT colonography: an imaging scan of the colon, usually every 5 years.
A positive result on a stool test, sigmoidoscopy or CT scan means a follow-up colonoscopy is needed. Your doctor can help you choose the test that suits you.
What Medicare Covers
Medicare Part B covers screening colonoscopies. According to Medicare.gov, coverage is once every 24, 48 or 120 months depending on your risk. People at high risk can be covered every 24 months, and others every 120 months, or every 48 months after a flexible sigmoidoscopy. There is no minimum age for a screening colonoscopy.
What you pay for a screening colonoscopy: nothing, if your provider accepts assignment. This includes a follow-up colonoscopy after a positive stool or blood test. If a polyp or other tissue is removed during the test, you pay 15% of the Medicare-approved amount for the provider, and a 15% coinsurance to the facility if it is a hospital outpatient department or surgery center. The Part B deductible does not apply.
Medicare.gov also lists coverage for stool-based and blood-based screening tests. If you have a Medicare Advantage plan, call your plan to confirm how it handles screenings and which providers to use.
A Few Practical Tips
- Ask the office whether your visit is billed as “screening” or “diagnostic.” The costs can differ.
- Confirm that the doctor and the facility both accept Medicare.
- Ask about the prep for a colonoscopy, and arrange a ride home, since you will likely be sedated.
- Tell your doctor about any symptoms, such as blood in the stool or a lasting change in bowel habits. Screening is meant for people without symptoms.
Questions about Medicare coverage can go to 1-800-MEDICARE (1-800-633-4227), or to a free SHIP counselor at shiphelp.org. Be wary of anyone who calls offering a “free” test kit and asks for your Medicare number.
This article is general information, not medical advice. Talk to your doctor or pharmacist about your own health.
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