Does Blue Cross Blue Shield Cover Medicare Colonoscopies?

In this article...
  • Colonoscopies are procedures that help detect colon cancer and other conditions. Blue Cross Blue Shield Medicare may help cover some costs. Learn more.

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A colonoscopy is a type of medical procedure in which a physician utilizes a specialized imaging device called a colonoscope to examine the inside of the colon and rectum. Colonoscopy screenings for colorectal cancer are recommended for all adults between the ages of 45 and 75.

Does Blue Cross Blue Shield Medicare Cover Colonoscopy Procedures?

Blue Cross Blue Shield typically covers colonoscopies for men and women aged 50 or older if they're considered at risk for developing colon cancer. It covers all costs of colonoscopy procedures for plan members who use in-network providers; however, costs for additional procedures, such as biopsies, may not be covered. 

Shop for Blue Cross Blue Shield Medicare Advantage plans that cover colonoscopies by clicking below. 

Medicare also provides coverage for colonoscopies once every 24 months for recipients who are considered at risk for developing colon cancer. Original Medicare covers 100% of colonoscopy exams for recipients who use physicians or health care providers who accept assignment. If the physician performs a biopsy or removes suspicious tissue during a colonoscopy procedure, the Medicare recipient may be required to pay 20% of the total Medicare-approved amount for the physician's services and/or a separate facility copayment if the procedure takes place in an outpatient hospital setting. 

What Are The Risk Factors for Developing Colon Cancer?

Some common risk factors for colon cancer include a family history of colorectal cancer and/or colorectal polyps, obesity, excessive alcohol consumption and tobacco use. Individuals with inflammatory bowel disease or ulcerative colitis may also be at higher risk for the disease. Lifestyle factors that may contribute to colon cancer include diets low in fruits and vegetables and a lack of daily exercise and physical activity.

How Do People Prep for Colonoscopies?

Individuals scheduled for colonoscopy procedures are usually provided with specific instructions to prepare the colon for the insertion of the colonoscope. Prep instructions include:

  • Eating low-fiber foods the second and third day prior to the procedure
  • Switching to a clear liquid diet the day before the procedure
  • Consuming liquid laxative the evening before and the day of the procedure to clean out the colon
  • Coordinating a ride home after the procedure 

Are Colonoscopies Painful? 

People are usually completely sedated during colonoscopies, so the actual procedure is generally pain-free. After the procedure, individuals may experience symptoms, such as mild stomach pain, gas, diarrhea and constipation. Serious side effects or complications are generally rare with colonoscopies, but heavy bleeding and/or severe pain following the procedure should be assessed by a medical professional. 

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