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Medicare Cancer Screening Coverage: Eligibility and Cost Differences

Adapted from Your Medicare Benefits, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Blood-based biomarker tests for colorectal cancer (screening)

Blood-based biomarker screening tests can help find cancer in the colon or rectum early, when treatment is most effective. Part B covers a blood-based biomarker screening test if you meet all these conditions:

  • You’re between 45–85.
  • You show no symptoms of colorectal disease (including, but not limited to, lower gastrointestinal pain, blood in stool, or positive guaiac fecal occult blood test or fecal immunochemical test).
  • You’re at average risk for developing colorectal cancer, meaning:
  • You have no personal history of adenomatous polyps, colorectal cancer, or inflammatory bowel disease (including Crohn’s Disease and ulcerative colitis).
  • You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.

How often Once every 3 years (if available).

Costs

  • You pay nothing for the test if your doctor or other health care provider accepts assignment.
  • If you get a positive result after a blood-based biomarker screening test, Medicare also covers a follow-up colonoscopy as a screening test.

More information Visit Medicare.gov/coverage/blood-based-biomarker-tests.

Cervical & vaginal cancer screenings

Cervical and vaginal cancer screenings check for cancer in the cervix and vagina. Part B covers Pap tests and pelvic exams. As part of the pelvic exam, Part B also covers a clinical breast exam to check for breast cancer.

How often Part B covers these screening tests once every 24 months in most cases. If you’re at high risk for cervical or vaginal cancer, or if you’re of child-bearing age and had an abnormal Pap test in the past 36 months, Part B covers these screening tests once every 12 months.

Part B also covers Human Papillomavirus (HPV) tests (as part of a Pap test) once every 5 years if you’re between 30–65 and don’t have HPV symptoms.

Costs If your doctor or other health care provider accepts assignment, you pay nothing for the:

  • Lab Pap test
  • Lab HPV test with the Pap test
  • Pap test specimen collection
  • Pelvic and breast exams

More information Visit Medicare.gov/coverage/cervical-vaginal-cancer-screenings.

Colonoscopies (screening)

Colonoscopy screening tests check for precancerous polyps (growths in the colon), cancer, and other diseases inside the rectum and colon. Part B covers screening colonoscopies. There’s no minimum age requirement to get a screening.

How often Part B covers this screening test once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Part B covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy.

If you initially have a Medicare-covered, non-invasive stool-based colorectal cancer screening test (fecal occult blood test or multi-target stool DNA test) or a blood-based biomarker screening test and get a positive result, Part B covers a follow-up colonoscopy as a screening test.

Costs

  • If your doctor or other health care provider accepts assignment, you pay nothing for screening test(s), including follow-up colonoscopies you get after a positive result from a Medicare-covered blood-based biomarker test or non-invasive stool-based test.
  • If your health care provider finds and removes a polyp or other tissue during the colonoscopy, you pay 15% of the Medicare-approved amount for your provider’s services. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15% coinsurance. The Part B deductible doesn’t apply.

More information Visit Medicare.gov/coverage/colonoscopies.

Colorectal cancer screenings

Colorectal cancer screenings help find precancerous polyps (growths in the colon) or find cancer early, when treatment is most effective. Medicare may cover one or more of these screening tests:

  • Colonoscopies (screening): Go to page 24.
  • Blood-based biomarker tests (screening): Go to page 14.
  • Computed tomography (CT) colonography (screening): Go to page 26.
  • Fecal occult blood tests (screening): Go to page 46.
  • Flexible sigmoidoscopy (screening): Go to page 47.
  • Multi-target stool DNA tests (screening): Go to page 76.

Computed tomography (CT) colonography (screening)

A CT colonography screening (also called a virtual colonoscopy) is a test that uses X-rays and computers to help find polyps (growths in the colon), ulcers (sores), and cancer in your colon and rectum. Part B covers this screening test if your doctor, physician assistant, nurse practitioner, or clinical nurse specialist orders it.

How often If you’re 45 or older and at high risk for colorectal cancer, Part B covers this screening test once every 24 months. If you aren’t at high risk, Part B covers the test once every 60 months, or 48 months after a previous flexible sigmoidoscopy or colonoscopy. If you’re under 45, Part B doesn’t cover this test.

Costs You pay nothing if your doctor or other health care provider accepts assignment.

More information

  • Go to:
  • “Colonoscopies (screening)” on page 24.
  • “Flexible sigmoidoscopy (screening)” on page 47.
  • Visit Medicare.gov/coverage/computed-tomography-ct-colonography.

Fecal occult blood tests (screening)

Fecal occult blood screening tests can help find cancer in the colon or rectum early, when treatment is most effective. Part B covers these screening tests if you get a referral from your doctor, physician assistant, nurse practitioner, or clinical nurse specialist.

How often If you’re 45 or older, once every 12 months. If you’re under 45, Medicare doesn’t cover this test.

Costs

  • You pay nothing for the test if your doctor or other health care provider accepts assignment.
  • If you get a positive result after a fecal occult blood screening test, Medicare also covers a follow-up colonoscopy as a screening test.

More information

  • Go to “Colorectal cancer screenings” on page 25.
  • Visit Medicare.gov/coverage/fecal-occult-blood-tests.

Flexible sigmoidoscopy (screening)

A flexible sigmoidoscopy is an endoscopic procedure that helps find cancer in the colon or rectum early, when treatment is most effective. Part B covers flexible sigmoidoscopy screenings.

How often For most people 45 or older, 48 months after a previous flexible sigmoidoscopy or computed tomography (CT) colonography. If you aren’t at high risk for colorectal cancer but have had a screening colonoscopy, 120 months after the previous screening colonoscopy.

Costs

  • You pay nothing for the test if your doctor or other health care provider accepts assignment.
  • If your health care provider finds and removes a lesion or growth during your flexible sigmoidoscopy screening, you’ll pay 15% of the Medicare-approved amount for your doctor’s services. In a hospital outpatient setting or ambulatory surgical center, you also pay the facility a 15% coinsurance. In these cases, the Part B deductible doesn’t apply.

More information

  • Go to “Colorectal cancer screenings” on page 25.
  • Visit Medicare.gov/coverage/flexible-sigmoidoscopies.

Lung cancer screenings

These screenings check for early signs of lung cancer in adults who are at risk of getting the disease. Part B covers lung cancer screenings with low dose computed tomography (also known as “CT scans”) if you meet all these conditions:

  • You’re between 50–77.
  • You don’t have signs or symptoms of lung cancer (you’re asymptomatic).
  • You’re either a current smoker, or you quit smoking within the last 15 years.
  • You have a tobacco smoking history of at least 20 “pack years” (an average of one pack (20 cigarettes) per day for 20 years).
  • You get an order from your doctor or other health care provider.

How often Once a year.

Costs You pay nothing if your health care provider accepts assignment.

Things to know Before your first lung cancer screening, you’ll need to schedule an appointment with your provider to discuss the benefits and risks and decide if a screening is right for you.

More information Visit Medicare.gov/coverage/lung-cancer-screenings.

Mammograms

Mammograms are x-ray pictures of the breast that check for breast cancer. There are different types of mammograms. A baseline mammogram (usually your first mammogram) creates a record of your breast tissue that’s compared to all future mammograms. A screening mammogram monitors your breast health every year. Diagnostic mammograms investigate abnormalities, including symptoms or signs of breast cancer. Part B covers:

  • A baseline mammogram if you’re a woman between 35–39
  • Screening mammograms if you’re a woman 40 or older
  • Diagnostic mammograms

How often

  • Baseline mammogram: Once in your lifetime.
  • Screening mammograms: Once every 12 months.
  • Diagnostic mammograms: More frequently than once a year, if medically necessary.

Costs

  • Baseline and screening mammograms: You pay nothing if your doctor or other health care provider accepts assignment.
  • Diagnostic mammograms: After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

Things to know Your health care provider may order a breast ultrasound after a mammogram to check specific areas of your breast. Medicare only covers medically necessary breast ultrasounds when your provider orders them.

More information Visit Medicare.gov/coverage/mammograms.

Multi-target stool DNA tests (screening)

Multi-target stool DNA screening tests check for genetic changes in a sample of your stool to look for signs of cancer in the colon or rectum. Part B covers these at-home screening tests if you meet all these conditions:

  • You’re between 45–85.
  • You show no symptoms of colorectal disease including, but not limited to, lower gastrointestinal pain, blood in stool, or a positive guaiac fecal occult blood test or fecal immunochemical test.
  • You’re at average risk for developing colorectal cancer, meaning:
  • You have no personal history of adenomatous polyps, colorectal cancer, or inflammatory bowel disease (including Crohn’s Disease and ulcerative colitis).
  • You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.

How often Once every 3 years.

Costs

  • You pay nothing for the test if your doctor or other health care provider accepts assignment.
  • If you get a positive result after a multi-target stool DNA screening test, Medicare also covers a follow-up colonoscopy as a screening test.

More information

  • Go to “Colorectal cancer screenings” on page 25.
  • Visit Medicare.gov/coverage/multi-target-stool-dna-tests.

Prostate cancer screenings

Prostate cancer screenings check for cancer in the prostate, a gland in the male reproductive system. Your doctor or other health care provider may find prostate cancer during a digital rectal exam, or through a test that checks the amount of prostate specific antigen (PSA) in your blood. Part B covers digital rectal exams and prostate specific antigen (PSA) blood tests for men over 50 (starting the day after your 50th birthday).

How often Once every 12 months.

Costs

  • Digital rectal exams: After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the digital rectal exam and for your doctor’s services related to the exam. In a hospital outpatient setting, you also pay a separate hospital visit copayment.
  • PSA blood tests: You pay nothing for the PSA blood test. If you get the test from a health care provider that doesn’t accept assignment, you may have to pay a fee for your doctor’s services, but not for the test itself.

More information Visit Medicare.gov/coverage/prostate-cancer-screenings.

Source and further reading

Your Medicare Benefits — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.

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