According to the American Cancer Society, as many as 2 million people in the United States will be diagnosed with cancer in 2024 alone.[efn_note]“Cancer Facts & Figures 2024” American Cancer Society. Accessed May 14, 2024[/efn_note] Detecting cancer earlier allows people to be treated sooner and can hopefully prevent complications and even deaths from the disease.
Whether or not you will pay cost sharing for any of these services depends upon whether the service is a screening test or a diagnostic test. Screening tests – performed on people who do not have signs or symptoms of disease – may not require cost sharing. Diagnostic services – performed when there are symptoms or abnormal findings, or more frequently than the recommended screening tests – typically require cost-sharing.
As an example, a patient who receives a mammogram performed for screening purposes would not have to pay cost sharing. However, a mammogram to evaluate a lump in that patient’s breast would be considered a diagnostic test – and would require cost sharing.
In a similar way, a colonoscopy or flexible sigmoidoscopy can be covered with no cost-sharing if performed at the screening intervals covered by Medicare. But if a polyp is found and removed, the patient will pay 15% of the Medicare-approved amount for the facility fee and the doctor’s services.[efn_note]“Colonoscopies” Medicare.gov. Accessed May 15, 2024[/efn_note]