Fecal occult blood tests are covered annually for all beneficiaries age 50 and over. This is the least expensive and least invasive colorectal cancer screening test. It detects blood in the stool that is an indication of the need for further investigation. Flexible sigmoidoscopy is covered every four years for beneficiaries not at high risk. It is more expensive and invasive and can require local anesthesia.
Colonoscopy is covered every two years for beneficiaries at high risk.
This is the most expensive and invasive colorectal screening option and can require anesthesia. But it gives the best view of entire colon and lesions can be removed for testing. Barium enemas are covered as an alternative if a physician determines that its screening value is equal to or greater than sigmoidoscopy or colonoscopy. The BBA authorized or expanded coverage of preventive services for several other diseases, as well, and in some cases reduced beneficiary cost sharing in order to further encourage use. Patients pay 20 percent of the Medicare approved amount, but there is no deductible.