Medicare Follow-up Colonoscopy

hero symbol

Our Priority:

Remove out-of-pocket costs for Medicare patients who need a colonoscopy following an abnormal result on a non-invasive colorectal cancer screening test.

Why This is Important:

  • At-home, non-invasive colorectal cancer screening tests can be a great option for patients at average risk to get screened. But if they receive an abnormal result, a colonoscopy is necessary to complete screening.
  • Cost should not be a barrier to completing potentially life-saving colorectal cancer screening.
  • Colorectal cancer is the second leading cancer killer in the United States, but if caught early, it can be prevented.
  • 1 in 3 people are not up to date on colorectal cancer screening. This was made worse by the COVID-19 pandemic when colorectal cancer screening declined by 86%.
  • Black, Hispanic, and Native Americans have lower screening rates and are diagnosed at later stages of colorectal cancer.

What We Are Doing:

We are working through our Catalyst State-by-State Advocacy Program to pass legislation at the state level to remove out-of-pocket costs for follow-up colonoscopy. We are also working at the federal level to ensure these costs are removed for Medicare patients as well.

Check out our blog post to learn more about how we helped ensure patients with commercial insurance won’t face out-of-pocket costs for a follow-up colonoscopy.

Background:

While colonoscopy is often considered to be the gold standard in colorectal cancer screening, there are also several noninvasive, at-home tests that also serve as good options for patients including: High sensitivity guaiac-based fecal occult blood test (hs-gFOBT), Fecal immunochemical tests (FIT), and Multitarget stool DNA test (i.e., Cologuard).