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Sign Up for FORCE NewslettersColon cancer screening starting at age 45
The Patient Protection and Affordable Care Act (ACA) focuses on the screening and preventive needs of Americans at average risk of cancer and other diseases. As a result, most health insurance companies cover colorectal cancer screening starting at age 45 with no out-of-pocket costs to the patient. There are some distinctions between screening and diagnostic exams. If polyps are found in a colorectal screening, future exams may be considered diagnostic and patients may incur out-of-pocket costs.
Health insurers usually cover colonoscopies for high-risk people under the age of 45 when recommended by expert medical guidelines but they are not required to cover this screening at 100% so patients often have to pay deductibles, coinsurance and copays.
Note that the ACA does not apply to Medicare or Medicaid. They have their own rules. See the Insurance & Reimbursement section of our website to learn more.
Related Resources
- See the Risk Management Guidelines for more information on the screenings and other interventions recommended for individuals with an inherited genetic mutation that causes increased risk of cancer.
- From Coverage to Care is an initiative designed to help people understand their health coverage benefits, and connect to primary care and preventive services.
- Healthcare.gov is a website administered by the U.S. Department of Health & Human Services which provides comprehensive information about health care and insurance provisions.
- The Office of Personnel Management provides ACA resources for Federal Employee Health Benefits Program (FEHBP) beneficiaries.
- The U.S. Department of Labor has a webpage on the Affordable Care Act for workers and families.
Paying For Care
- Problems with insurance coverage of colonoscopies or other recommended screening and preventive services? Visit our section on Insurance & Reimbursement for guidance.