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SUMMER / 2007

Medicare Coverage for Colon Cancer Screenings

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Benefits for individuals of average risk, age 50 or older:
> Fecal occult blood test (FOBT), every 12 months
> Flexible sigmoidoscopy, every 48 months
> Screening colonoscopy, every 10 years (no minimum age)
> Barium enema, an alternative to flexible sigmoidoscopy or colonoscopy if your physician determines its screening value is equal or better

Benefits for high-risk* individuals, regardless of age:
> FOBT, every 12 months
> Sigmoidoscopy, every 48 months
> Colonoscopy, every 24 months
> Barium enema, every 24 months

What you’ll pay:
> FOBT, completely covered by Medicare 
> Flexible sigmoidoscopy, colonoscopy or barium enema, 20 percent of Medicare-approved amount after yearly Part B deductible if done in a doctor’s office (and 25 percent for a flexible sigmoidoscopy or colonoscopy done in a hospital outpatient department)

*You’re high risk if you have:
> previously had colorectal cancer 
> a close relative with colorectal polyps or cancer
> a history of polyps
> inflammatory bowel disease

 

For information about Medicare coverage of cancer screenings and about risk factors, visit www.medicare.gov/Health/cancer.asp. To learn about the Welcome to Medicare visit, see www.medicare.gov/health/physicalexam.asp

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