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If you’re preparing for your first colonoscopy, you may have questions about the exam. You may also be wondering if it is covered by your Aetna plan. Get answers to these questions and more below. 

What is a Colonoscopy?

Colonoscopies are used to screen for colon cancer. During this exam, your doctor will look for:

  • Changes in the colon and rectum lining
  • Polyps
  • Swollen or irritated tissues

Most colon polyps are harmless. But over time, they could turn into cancer. This is why you should get regular screenings. If found early, most polyps can be removed safely by your doctor.

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Does Aetna Medicare Cover Colonoscopies?

Yes. Aetna Medicare Advantage plans cover a screening every 10 years. If you have a family history of colon cancer, your plan may cover screenings more often. 

When Would a Doctor Recommend a Colonoscopy?

Your doctor may order a colonoscopy to:

  • Diagnose a medical condition: If you have stomach pain or changes in bowel habits, your doctor may recommend a colonoscopy to figure out the cause of your symptoms.
  • Screen for cancer: If you are 45-75 years old, your doctor may recommend a colonoscopy every 10 years to screen for cancer.3
  • Look for polyps: If you’ve had polyps removed before, your doctor may suggest a follow-up colonoscopy to make sure they haven’t come back.

Is There a Copay for Colonoscopies?

You typically don’t pay a copay if you are at least 45 years old and stay within network. Read your plan’s Evidence of Coverage for more details about what’s covered. You can also call a licensed insurance agent for help.

Does Aetna Medicare Cover Other Screenings for Colon Cancer?

Yes. Aetna Medicare Advantage plans cover other types of screenings to help detect colon cancer. These screenings include:

•    Cologuard Stool DNA Test 
•    Fecal Immunochemical Test
•    Fecal Occult Blood Test
•    Flexible Sigmoidoscopy 

You should talk to your doctor to decide which screening is right for you. A copay may apply for these screenings.  

If you have questions about your plan benefits, please reach out to a licensed insurance agent.

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