Coverage

Coverage

Screening Flexible Sigmoidoscopy

Medicare covers a screening flexible sigmoidoscopy once every four years for beneficiaries 50 and older. If a beneficiary had a screening colonoscopy in the previous 10 years, then the next screening flexible sigmoidoscopy would be covered only after 119 months have passed following the month in which the last screening colonoscopy was performed.

Screening Colonoscopy

Medicare coverage for a screening colonoscopy is based on beneficiary risk.

For beneficiaries 50 and older not considered to be at high risk for developing colorectal cancer, Medicare covers one screening colonoscopy every 10 years, but not within 47 months of a previous screening flexible sigmoidoscopy.

For beneficiaries considered to be at high risk for developing colorectal cancer, Medicare covers one screening colonoscopy every two years, regardless of age.

This is from Medicare.gov

  • Colonoscopy: Medicare covers this test once every 24 months if you're at high risk for colorectal cancer. If you aren't at high risk for colorectal cancer, Medicare covers this test once every 120 months, or 48 months after a screening flexible sigmoidoscopy.
  • Flexible Sigmoidoscopy: Medicare covers this test once every 48 months for most people 50 or older. If you're not at high risk, Medicare covers this test 120 months after a previous screening colonoscopy.

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