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Does Medicare Cover Cancer Screenings?

Medicare Bob
Medicare General Info
Medicare offers coverage for regular screenings of cancers frequently seen in older Americans, like breast, colorectal, lung cancer and more.
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Advancements in science and technology help make it possible for us to live longer lives. But with aging comes a higher risk of cancer. In fact, people 65 and older account for 70% of the world’s cancer-related deaths.

Studies of men and women over 70 showed the most frequently seen cancer types in women to be breast and colorectal cancers, while lung and prostate cancers were the most frequent types in men.

Armed with this knowledge, Medicare beneficiaries can also have peace of mind with coverage for cancer screenings for prevention or to catch things early enough that your cancer can be treated.

Medicare Covers These Cancer-Related Screenings

Medicare Part B covers mammograms and cervical and vaginal cancer screenings. Unless your doctor says it’s medically necessary for more, Medicare covers:

When it comes to screenings for colorectal cancer, Medicare covers several lab, in-office and at-home tests, including:

  • Multi-target stool DNA tests: An at-home test once every three years, as long as you show no signs of colorectal disease and are at average risk

  • Barium enemas: An in-office test once every 48 months, or once every 24 months if you’re at high risk for colorectal cancer

  • Screening fecal occult blood tests: A lab test once every 12 months with a referral from your healthcare provider

  • Screening flexible sigmoidoscopies: An in-office screening — similar to a colonoscopy but exploring only the lower part of the colon — once every 48 months for people 50 or older or 120 months after a previous colonoscopy.

  • Colonoscopies: An in-office screening once every 24 months for those at high risk of colorectal cancer. For those who aren’t high risk, this test is covered once every 120 months or 48 months after a flexible sigmoidoscopy.

Lung cancer screenings are covered under Medicare Part B once a year for those meeting all of these conditions:

  • Between 55 and 77

  • No symptoms of lung cancer

  • You’re a current smoker or have quit within the last 15 years

  • You’ve had at least 30 “pack years,” or an average of one pack per day for 30 years

  • You have a written order from a Medicare-accepting doctor

Medicare Part B also covers prostate cancer screenings in two parts once every 12 months if you’re a man over 50:

  • A digital rectal exam, for which you’d pay 20% to your doctor, and the Part B deductible applies. If it’s a hospital outpatient procedure, you’ll pay a copay. 

  • A prostate-specific antigen blood test, which is 100% covered by Medicare

Medicare Cancer Screening Costs

It’s important to note that these cancer screenings are covered completely by Medicare unless something is found that requires biopsy or removal. In that case, further Medicare Part B deductibles and copays can come into play.

Screening tests like these have been shown to be effective in detecting cancer early, helping to give you a longer, happier life. Talk to your primary care physician about cancer screenings today. 

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.

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