Medicare Coverage for Colorectal Screenings
April 5, 2007
Kishwaukee Community Hospital recognizes the importance of colon screenings and is excited to share information about Medicare’s updated coverage for such screenings.
Colorectal cancer is largely preventable through screening, which can find colon growths called polyps that can be removed before they turn into cancer. Screening can also detect cancer early when it is easier to treat and cure.
Screening for colorectal cancer is recommended for all adults ages 50 and older, although screening may start at younger ages for individuals who are at high risk for colon cancer. The frequency of screening is based on an individual’s risk for colorectal cancer and the type of screening test that is used.
An individual is considered to be at high risk for colorectal cancer if he or she has had colorectal cancer before or has a history of polyps, has a family member who has had colorectal cancer or a history of polyps, or has a personal history of inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis.
In addition, risk for colorectal cancer increases with age. It is important to encourage patients who were screened before entering Medicare to continue with screening at clinically appropriate intervals.
Medicare Covers Screening Tests
Medicare covers the following screening tests to detect colorectal cancer early, when it is most treatable, and to identify people at high risk for developing this type of cancer:
- Fecal Occult Blood Test (FOBT)—Medicare covers both guaiac and immunoassay tests, but Medicare will only pay for one FOBT each year
- Colonoscopy—Medicare covers every 10 years for normal risk; more frequently for high risk persons
- Sigmoidoscopy—Medicare covers every 4 years
- Barium Enema—Medicare covers every 4 years for normal risk; every 2 years for high risk
New Coverage Information for 2007
Starting in January 2007, Medicare waived the requirement that beneficiaries meet the deductible for screening colonoscopy, sigmoidoscopy, or barium enema (as an alternative to colonoscopy or sigmoidoscopy).