Cologuard is an at-home colon cancer screening kit that detects changes in genetic material indicating potential colon cancer or polyps.
It’s popular due to its noninvasive nature and convenience compared to a colonoscopy. If you have Medicare, your plan will cover one kit every three years under Original Medicare (Parts A and B).
Anyone enrolled in Medicare ages 45 years and above is eligible for coverage for one Cologuard test every three years.
This is in line with the recommendations of the U.S. Preventative Services Taskforce (USPSTF) for screening for colorectal cancer in all adults ages 50 to 75 years and those over 75 based on a doctor’s recommendation.
You’re typically eligible for Medicare at the age of 65, but you may be eligible sooner if you are living with end stage renal disease or amyotrophic lateral sclerosis (ALS).
Learn more about Medicare enrollment age and other eligibility requirements.
In addition to the age requirement, there are a few other criteria for Cologuard coverage under Medicare.
First, you can’t have noticeable symptoms or signs that may already indicate colon problems, such as stomach pain, blood in your stool, or any type of positive result on either a urine or blood test.
You also need to be of average risk for colon cancer. This means that the test might not be covered if there are factors that increase your risk of developing the cancer.
These factors include:
- a family history of colon cancer
- a previous cancer
- a history of conditions like adenomatous polyps or inflammatory bowel disease
Ask your doctor whether Cologuard is a good option for you instead of or before considering a colonoscopy.
Learn more about cancer screening and Medicare.