Does Medicare Pay for a Colonoscopy After 75?

Yes. Medicare Part B pays for a colonoscopy after 75, and it keeps paying past 80, 85, and beyond. There is no upper age limit on the benefit. If the procedure is coded as a screening and your providers accept Medicare assignment, your out-of-pocket cost is zero. The harder question at your age isn’t whether Medicare covers the procedure. It’s whether the procedure still makes sense for you, and what smaller charges can sneak in around the edges.

How Often Medicare Will Cover a Screening at Your Age

The frequency rules don’t change once you pass 75. They depend on your risk level, not your birthday.

Average risk: once every 120 months (10 years), or once every 48 months after a previous flexible sigmoidoscopy.¹
High risk: once every 24 months. You’re considered high risk if you have a personal history of colorectal cancer, polyps, or inflammatory bowel disease, or a close family history of the disease.¹

So if you had a clean screening at 70 and you’re at average risk, Medicare won’t pay for another until you’re 80. If you’re high risk, you’re eligible again two years out.

What You’ll Actually Pay

When the procedure stays classified as a screening, Medicare Part B pays 100% of the approved amount and the Part B deductible ($283 in 2026) does not apply.¹² Zero cost. That’s the headline, and it depends entirely on the provider accepting Medicare assignment.

Costs appear in three places most people don’t expect.

If a Polyp Is Found and Removed

Once your doctor removes a polyp or tissue, a diagnostic component is added to what began as a screening. For dates of service through 2026, the Part B deductible is still waived, but you owe a reduced coinsurance of 15% of the Medicare-approved amount for the doctor’s services. If the procedure happens at a hospital outpatient department or ambulatory surgical center, you also pay 15% coinsurance on the facility fee.¹³

That 15% is lower than the usual 20% Part B coinsurance, and a Medigap policy may cover some or all of it depending on your plan letter. This is not a reason to refuse polyp removal during the procedure. Coming back for a separate procedure later costs more and carries its own risks.

Sedation

When anesthesia or moderate sedation is provided alongside a screening colonoscopy, the deductible and coinsurance are both waived, the same as the procedure itself.³ If a polyp is found and the procedure shifts to include a diagnostic component, the deductible on anesthesia services remains waived through 2026, though coinsurance rules for the sedation may differ from the procedure itself. Confirm the anesthesiologist accepts Medicare assignment before the day of the procedure.

The Pre-Procedure Office Visit

Your gastroenterologist will usually schedule a consultation to go over your history and the prep. That visit is billed as a standard Part B service, not as part of the screening benefit. You’ll owe your normal 20% Part B coinsurance after meeting the $283 annual deductible.² This is the charge that most often catches people off guard.

Should You Still Be Screened After 75?

Medicare pays. That doesn’t automatically mean you should go. The U.S. Preventive Services Task Force recommends routine colorectal cancer screening for all adults through age 75. For adults between 76 and 85, the Task Force issues a weaker recommendation: screening should be selective, based on your overall health, life expectancy, prior screening history, and personal preferences.⁴ After 85, the Task Force recommends discontinuing screening entirely, on the reasoning that competing health risks outweigh the potential benefit.

The practical version of this: a healthy 78-year-old who has never been screened is a very different case from an 82-year-old with significant other conditions and a clean colonoscopy five years ago. Medicare pays in both cases. Your doctor is the one who can tell you whether the benefit is worth the prep, the sedation, and the small procedural risks at your point in life.

Gentler Screening Options Medicare Covers

If the prep and sedation are what you want to avoid, Medicare covers several alternatives to a full colonoscopy. Each is free when the provider accepts assignment.

Fecal occult blood test or FIT: a stool-based test covered once every 12 months for beneficiaries age 45 and older.⁵
Stool DNA test (Cologuard): covered once every three years for average-risk beneficiaries who are asymptomatic, with no personal or family history of polyps, colorectal cancer, or inflammatory bowel disease.⁶
CT colonography (virtual colonoscopy): covered once every 60 months for average-risk beneficiaries, or every 24 months for high-risk beneficiaries, starting at age 45.⁷
Blood-based biomarker test: covered once every three years for average-risk beneficiaries ages 45 to 85 with no symptoms or history of colorectal disease.⁸

One catch on all of them: a positive result on any non-invasive test sends you back to a colonoscopy for confirmation. Medicare covers that follow-up colonoscopy as a screening, so the same zero-cost rules apply.⁵⁸

If You’re on Medicare Advantage

A Medicare Advantage (Part C) plan must cover at least everything Original Medicare covers, including screening colonoscopies on the same frequency rules.⁹ Cost-sharing can look different: a flat copay instead of coinsurance, and network rules that Original Medicare doesn’t impose. Before you schedule, call the number on your member card and confirm the gastroenterologist, the anesthesiologist, and the facility are all in-network. An out-of-network provider can turn a preventive procedure into a real bill.

How to Keep a Free Screening Free

Ask your doctor to code the procedure as a screening. If you’re going in because of symptoms like bleeding or abdominal pain, it will be classified as diagnostic from the start, and standard Part B cost-sharing (20% coinsurance after the $283 deductible) applies to the whole procedure.
Verify Medicare assignment for every provider involved: the gastroenterologist, the anesthesiologist, and the facility. One out-of-network provider is enough to generate a bill.
Budget for the pre-procedure consultation. It’s billed separately and is not part of the screening benefit.
Know what happens if a polyp is found. You’ll owe 15% coinsurance on the doctor’s services and possibly the facility fee. Removing the polyp during the same procedure is still the right call.

For a Medicare beneficiary over 75, the coverage answer is simple. The medical answer takes a conversation with the doctor who knows your history.

1
Medicare.gov. Colonoscopies (screening)
2
Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles
3
CMS Manual System. Medicare Claims Processing Manual Chapter 18 – Preventive and Screening Services
4
United States Preventive Services Task Force. Recommendation: Colorectal Cancer: Screening
5
Medicare.gov. Fecal Occult Blood Tests (screening)
6
Centers for Medicare & Medicaid Services. NCA – Screening for Colorectal Cancer – Stool DNA Testing
7
Medicare.gov. Computed Tomography (CT) Colonography
8
Medicare.gov. Blood-Based Biomarker Tests
9
Medicare.gov. Compare Original Medicare and Medicare Advantage