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Colorectal Cancer >
Screen for Life > Facts for People with
Medicare
Facts for People with Medicare
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Questions about Medicare Coverage?
Call 1-800-663-4227
TTY 1-877-2048 www.medicare.org*
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Screening Tests and Medicare Coverage
Several tests can be used to detect polyps or colorectal
cancer. Each one can be used alone. Sometimes they are used in combination
with each other. People age 50 or older with Medicare are eligible for
colorectal cancer screening. There is no age limit for colonoscopy.
- Fecal Occult Blood Test or Stool Test
You receive a test kit from your doctor or health care provider. At
home, you put a small stool sample on a test card. You do this for three
bowel movements in a row. Then you return the test cards to the doctor or
a lab. The stool samples are checked for blood.
Medicare: Covers once a year. You pay nothing.
- Flexible Sigmoidoscopy
The doctor puts a short, thin, flexible, lighted tube into your rectum.
The doctor checks for polyps or cancer inside the rectum and lower third
of the colon.
Medicare: Covers every 4 years. You pay 20% of approved amount
after Part B deductible.*
- Fecal Occult Blood Test Plus Flexible Sigmoidoscopy
Your doctor may ask you to have both tests. Some experts believe that by
using both, there is a better chance of finding polyps or colorectal
cancer.
Medicare: See above.
- Colonoscopy
This is similar to flexible sigmoidoscopy, except the doctor uses a longer
tube to check for polyps or cancer inside the rectum and the entire colon.
During the test, the doctor can find and remove most polyps and some
cancers. You will be given medication to help you relax and are advised
not to drive or work on the day of the exam.
Medicare: Covers every 10 years if you are not at high risk for
colorectal cancer, but not within 4 years of having screening flexible
sigmoidoscopy. Covers every 2 years if you are at high risk. Covers every
2 years if you are at high risk. There is no age limit for colonoscopy.
You pay 20% of Medicare approved amount after yearly Part B deductible.*
Colonoscopy also may be used a as follow-up test if anything unusual is
found during one of the other screening tests. Medicare covers follow-up
colonoscopy.
- Barium Enema
You are given an enema with a liquid called barium. Then the doctor takes
an x-ray. The barium allows the doctor to see the outline of your colon on
the x-ray to check for polyps or anything else that needs to be checked.
Medicare: Your doctor may order this test as a substitute for
flexible sigmoidoscopy or colonoscopy. It is covered every 4 years if you
are not at high risk or covered every 2 years if you are at high risk for
colorectal cancer. You pay 20% of approved amount after the yearly Part B
deductible.
* If flexible sigmoidoscopy or colonoscopy is done in an ambulatory
surgical center or hospital outpatient department, you pay 25% of Medicare
approved amount.
More Information
For more information about Medicare coverage, call
1-800-MEDICARE (18006334227). TTY users should call 18772048. Or
visit www.medicare.org.*
For more information about colorectal cancer and
screening, visit CDC | Cancer Prevention and
Control or call the National Cancer Institute's Cancer
Information Service: 18004CANCER. For TTY call 18003328615.
*Links to non-Federal organizations found at this site are
provided solely as a service to our users. These links do not constitute an
endorsement of these organizations or their programs by CDC or the Federal
Government, and none should be inferred. The CDC is not responsible for the
content of the individual organization Web pages found at these links.
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This Web site is intended for information only and is not
a substitute for medical care or treatment by a qualified professional. Any
person who has or might have a health problem should consult a professional
health care provider.
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