Medicare Cancer Screenings: What Is Covered and How Often
Early detection saves lives -- and Medicare covers screenings for the most common cancers at no cost. Here is exactly what cancer screenings Medicare covers, how often, and who qualifies.
Medicare Cancer Screenings: What Is Covered and How Often
Cancer caught early is far more treatable than cancer caught late. Medicare covers screenings for the most common cancers -- colorectal, breast, cervical, prostate, and lung -- at no cost to you. Here is exactly what is covered, how often, and who qualifies.
Colorectal Cancer Screening
Colorectal cancer is the second leading cause of cancer death in the United States -- and one of the most preventable with regular screening.
Colonoscopy:
- High risk: Every 2 years (family history of colorectal cancer or polyps, personal history of polyps or colorectal cancer, inflammatory bowel disease)
- Average risk: Every 10 years starting at age 45
- Cost: $0 -- no deductible, no coinsurance for the screening colonoscopy itself
- Important: If a polyp is found and removed during a screening colonoscopy, the procedure may be reclassified as therapeutic -- triggering cost-sharing. Ask your doctor about this before your procedure.
Flexible sigmoidoscopy:
- Every 48 months (every 2 years if combined with a fecal occult blood test)
- Cost: $0
Fecal occult blood test (gFOBT) or fecal immunochemical test (FIT):
- Annually
- Cost: $0
Stool DNA test (Cologuard):
- Every 3 years for average-risk adults 50-85
- Cost: $0
CT colonography (virtual colonoscopy):
- Every 5 years
- Cost: $0
Breast Cancer Screening (Mammogram)
Screening mammogram:
- Annually for women 40 and older
- Cost: $0 -- no deductible, no coinsurance
- Diagnostic mammogram (when a problem is suspected): Subject to standard Part B cost-sharing (20% coinsurance)
Cervical and Vaginal Cancer Screening
Pap smear and pelvic exam:
- Every 24 months for all women
- Every 12 months for high-risk women (history of cervical or vaginal cancer, abnormal Pap smear, DES exposure before birth)
- Cost: $0
HPV test:
- Every 5 years for women 30-65 (co-test with Pap smear)
- Cost: $0
Prostate Cancer Screening
PSA (prostate-specific antigen) blood test:
- Annually for men 50 and older
- Cost: $0 -- no deductible, no coinsurance
- Digital rectal exam: Covered as part of the prostate cancer screening benefit
Lung Cancer Screening
Low-dose CT (LDCT) scan:
- Annually for adults ages 50-77 who meet ALL of the following:
- Currently smoke or quit within the past 15 years
- Have a 20 pack-year smoking history (1 pack/day for 20 years, or equivalent)
- Have no signs or symptoms of lung cancer
- Receive a written order from a doctor or qualified non-physician practitioner
- Cost: $0 -- but requires a counseling and shared decision-making visit first
Skin Cancer Screening
Medicare does not cover routine skin cancer screening (full-body skin exam) as a preventive benefit. However, if you have a suspicious lesion, your doctor can evaluate it as a medically necessary service under Part B (subject to standard cost-sharing).
Oral Cancer Screening
Medicare does not cover routine oral cancer screening. Dental services are generally not covered by Original Medicare.
Making the Most of Cancer Screenings
- Schedule screenings at your Annual Wellness Visit -- your doctor will recommend which screenings are appropriate for your age and risk factors
- Keep records of when you had each screening and when the next one is due
- Don't skip screenings because you feel healthy -- many cancers cause no symptoms until advanced stages
We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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About the Author
William Gray
Independent Medicare BrokerUS Air Force Veteran · Florida Medicare Specialist
William Gray is an independent Medicare insurance broker based in Daytona Beach and Palm Coast, FL. A US Air Force veteran (A-10 crew chief, Germany), he spent years in corporate insurance before going independent to serve Florida seniors directly. He has helped more than 1,000 clients across Northeast Florida compare Medicare Advantage, Medigap, and Part D plans — always at no cost to the client.