Does Cigna Healthcare Cover a Colonoscopy?
- Colonoscopies help prevent colorectal cancer and diagnose the disease promptly. Cigna Healthcare Medicare Advantage plans cover a colonoscopy for eligible plan members. Learn more about eligibility and restrictions.
The U.S. Preventive Services Task Force recommends that people between 45 and 75 undergo regular colon cancer screening.
A Cigna Healthcare Medicare Advantage (Medicare Part C) plan covers a colonoscopy in the same way that Original Medicare (Medicare Parts A and B) covers colonoscopies. Some Cigna Healthcare Medicare Advantage plans may also cover additional health and wellness benefits that Original Medicare doesn't cover.
Does Cigna Healthcare Cover Colonoscopy?
Generally, Cigna Healthcare Medicare policies cover a colonoscopy if you're eligible.
Adults over 45 with an average risk of developing colorectal cancer receive coverage for a diagnostic colonoscopy every 10 years or a computed tomographic colonoscopy every 5 years.
Cigna Healthcare plans also cover several other colorectal cancer screening tests for enrollees aged 45 and over, including:
- Yearly fecal occult blood or immunochemical tests
- Barium enemas and flexible and flexible sigmoidoscopies every 5 years
- Fecal DNA tests every 1 to 3 years
Who Is Eligible for Cigna Healthcare Medicare Colonoscopy Coverage?
Although Cigna Healthcare Medicare policies generally restrict how often you can have a covered colonoscopy, your plan may cover more regular screening if it's medically necessary.
Generally, Cigna Healthcare considers more regular screening essential if you have a personal or family history of colorectal cancer or an inflammatory bowel condition like Crohn's disease.
You may also be entitled to more regular colonoscopy screenings if you have an increased risk of developing colorectal cancer for other reasons. For example, you may require regular surveillance if a doctor diagnosed adenoma or adenomatous polyps during a previous colonoscopy or if a close family member has a similar diagnosis.
Are Colonoscopies Free Under Medicare?
Generally, Original Medicare covers a colonoscopy every 10 years if you have an average risk of developing colorectal cancer. However, you may be eligible for a covered colonoscopy every 2 years if you are at higher risk.
All Medicare enrollees are entitled to colonoscopy coverage regardless of their age.
Does Medicare Cover the Full Cost of a Colonoscopy?
Original Medicare beneficiaries don't pay anything for a covered colonoscopy if your chosen provider accepts Medicare assignment, and you won't need to pay the Part B deductible.
Beneficiaries may need to pay 20% of the Medicare-approved amount for any treatment your doctor recommends based on their findings. You may also need to make a copayment for any outpatient services you require following your colonoscopy.
Your Cigna Medicare Advantage plan may feature deductibles or copays that are different from Original Medicare, so be sure to speak with a Cigna Healthcare representative about your coverage before getting a colonoscopy from your doctor.
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