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.
