It’s a fact that getting regular colonoscopies starting at age 45 reduces the risk of colon cancer by 89%.
The good news is most insurance carriers will fully cover the cost for screening colonoscopies, still the gold standard for colon cancer detection and prevention. *
In some cases, depending on the type of colonoscopy, patients must pay part of the cost. Because each situation is different, we strongly encourage patients to contact their insurance carrier about their coverage before their procedure to avoid surprise costs.
Preventative/Screening Colonoscopy – if your patient is at average risk for colon cancer
What is it?
- A routine screening starting at age 45 and then every 10 years.
- Recommended for patients with no past or present GI symptoms and no personal or family history of colon polyps and/or colon cancer.
What does insurance cover?
- Insurance typically covers 100% of preventative colonoscopies. Some out-of-pocket costs may apply.
- For a few insurance carriers, if a polyp is removed during the test, the procedure is converted to a diagnostic colonoscopy and insurance may not cover the full cost. The patient would be responsible for deductible, co-insurance, and co-pays.
Diagnostic/Surveillance Colonoscopy – if your patient is at higher-risk for colon cancer
What is it?
- Diagnostic colonoscopy is recommended for patients who have GI symptoms (rectal bleeding, abdominal pain, diarrhea).
- Surveillance colonoscopy is recommended for patients who have past and/or present polyps or GI disease (i.e., IBD) or have significant personal or family history of colon polyps and/or colon cancer.
- Repeat screening timeline is recommend depending on patient’s situation.
What does insurance cover?
- Insurance may not cover the full cost. Patient will need to pay deductible, co-insurance, and copays.
Colonoscopy Screening patient Printout
We’ve created an at-a-glance comparison of colon cancer screening efficacy to use in your clinics when discussing colonoscopy with your patients.
Click to Download:
References
Colonoscopy: 91 to 100% accurate detection of advanced precancerous polyps (Source)
Cologuard®: 42% accurate detection (Source)
FIT (Fecal Immunochemical Test): 23.8% accurate detection (Source)
Blood test: 13% accurate detection (Source)
