Yes, Medicare covers screening colonoscopies after age 70 with no upper age limit. There is no cutoff at 70, 75, 80, or any other age. As long as you have Medicare Part B, the procedure is covered at the same intervals regardless of how old you are.
That said, clinical guidelines and Medicare’s coverage rules don’t always align perfectly, and the details around cost sharing, screening frequency, and alternative tests vary depending on your risk level. Here’s what you need to know.
How Often Medicare Covers Screening Colonoscopies
Medicare Part B divides coverage into two tracks based on your risk for colorectal cancer.
If you’re at average risk, Medicare covers one screening colonoscopy every 10 years (120 months). If you had a flexible sigmoidoscopy instead of a colonoscopy at your last screening, coverage kicks in after 4 years (48 months).
If you’re at high risk, Medicare covers a screening colonoscopy every 2 years (24 months). You qualify as high risk if any of the following apply:
- A parent, sibling, or child has had colorectal cancer or adenomatous polyps
- A family history of familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer
- A personal history of adenomatous polyps
- A personal history of colorectal cancer
- Inflammatory bowel disease, including Crohn’s disease or ulcerative colitis
These coverage intervals apply at any age. Whether you’re 71 or 91, the schedule stays the same.
What Clinical Guidelines Actually Recommend
While Medicare doesn’t impose an age cap, medical guidelines are more nuanced. The U.S. Preventive Services Task Force recommends routine colorectal cancer screening for adults ages 45 to 75. Between ages 76 and 85, the Task Force says the decision should be individualized, meaning it depends on your overall health, life expectancy, prior screening history, and personal preferences.
This doesn’t mean screening after 75 is pointless. It means the benefit shrinks for people who have been regularly screened and have consistently clean results, because the chance of developing a dangerous new growth in that window is relatively small. For someone who has never been screened, or who has risk factors, a colonoscopy well into their 80s could still catch something important. The key point: Medicare will pay for it either way. The question of whether it makes sense for you is a clinical conversation, not a coverage issue.
What You’ll Pay Out of Pocket
For a straightforward screening colonoscopy where nothing is found, Medicare Part B covers the full cost. You pay nothing: no deductible, no copay, no coinsurance.
However, there’s a catch that surprises many people. If the doctor finds and removes a polyp during the procedure, the colonoscopy gets reclassified from “screening” to “diagnostic.” Under Medicare’s current rules, that triggers a 20% coinsurance charge, which can translate to $300 or more out of pocket. This bill typically arrives weeks after the procedure, since neither you nor your doctor knew a polyp would be found when the colonoscopy started.
Anesthesia is covered separately. Part B covers anesthesia for outpatient colonoscopies performed in a hospital outpatient department or ambulatory surgical center, though you may owe a copayment to the facility. If you have a Medigap (supplemental) policy, it may pick up some or all of these extra costs.
Medicare Advantage Plans
If you’re enrolled in a Medicare Advantage plan (Part C), your plan is required to cover at least everything Original Medicare covers. That means screening colonoscopies at the same intervals and with the same $0 cost sharing for a clean screening. Some Advantage plans offer additional benefits or lower cost sharing on diagnostic procedures, but the baseline coverage cannot be less than what you’d get with Original Medicare.
Non-Invasive Alternatives Medicare Covers
If you’d prefer to avoid the prep and sedation of a colonoscopy, Medicare covers a stool DNA test (sold under the brand name Cologuard) once every three years. This at-home test analyzes a stool sample for DNA markers associated with colorectal cancer and precancerous growths. To qualify for coverage, you need to be between 45 and 85, have no symptoms of colorectal disease, and be at average risk, meaning no personal or family history of polyps, colorectal cancer, or inflammatory bowel disease.
That 85-year age cap is one of the few places where Medicare does draw an age-related line for colorectal screening. It applies only to the stool DNA test, not to colonoscopy itself. If you’re over 85 and want screening, colonoscopy remains the covered option.
Medicare also covers fecal occult blood tests once every 12 months. These are simpler stool-based tests that look for hidden blood, though they’re less sensitive than the stool DNA test or colonoscopy. A positive result on any stool-based test will lead to a follow-up colonoscopy, which Medicare covers as a diagnostic procedure.
Screening vs. Diagnostic: Why the Label Matters
The distinction between a “screening” and “diagnostic” colonoscopy affects your bill more than most people realize. A screening colonoscopy is one scheduled as routine prevention when you have no symptoms. A diagnostic colonoscopy is ordered because you have symptoms (bleeding, unexplained weight loss, changes in bowel habits) or because a prior test came back positive.
Diagnostic colonoscopies are covered under Medicare Part B, but they’re subject to the standard 20% coinsurance after you meet your annual Part B deductible. So if your doctor orders a colonoscopy because of symptoms rather than as a routine screen, expect to pay a share of the cost. This is true at any age, but it becomes more relevant after 70 because gastrointestinal symptoms tend to prompt more frequent diagnostic procedures.
If you’re unsure how your colonoscopy will be billed, ask your doctor’s office before the procedure whether it’s being scheduled as a screening or diagnostic test. That one distinction can be the difference between a $0 bill and several hundred dollars.