Quick answer
Yes. ACA-compliant plans must cover screening colonoscopies at no cost for adults 45 to 75 when you use an in-network provider, and Medicare covers them too. Screening stays free if a polyp is removed on a private plan, and a follow-up colonoscopy after a positive stool test counts as screening. A colonoscopy done to check symptoms is diagnostic, so your deductible and coinsurance can apply.
Key takeaways
- Screening is recommended for adults 45 to 75, and private plans must cover it at no cost in network.
- Removing a polyp during a screening colonoscopy can’t trigger cost-sharing on ACA plans.
- A follow-up colonoscopy after a positive stool test is covered as screening.
- On Medicare, polyp removal means 15% coinsurance in 2026, falling to 10% in 2027.
- Make sure the facility, doctor and anesthesiologist are all in network.
On this page
Screening vs. diagnostic colonoscopy
| Type | Why it’s done | What you pay on an ACA plan |
|---|---|---|
| Screening | Routine check with no symptoms | Nothing, in network |
| Screening with polyp removal | Polyp found and removed during screening | Nothing, in network |
| Follow-up after a positive stool test | Completes the screening process | Nothing, in network |
| Diagnostic | Checking symptoms like bleeding, or monitoring a known condition | Your deductible, copay or coinsurance can apply |
Medicare coverage
Medicare covers a screening colonoscopy once every 120 months for most people, or every 24 months if you’re at high risk. You pay nothing if your provider accepts assignment. If a polyp is removed, you pay 15% of the Medicare-approved amount in 2026, and the facility may charge a 15% coinsurance too. That drops to 10% from 2027 through 2029, then to zero. See health insurance for the elderly.
How to avoid surprise costs
- Confirm the gastroenterologist, facility and anesthesia provider are in network. See what to do about out-of-network costs.
- Ask how the procedure will be coded: screening or diagnostic.
- Ask whether the bowel prep kit is covered.
- Ask whether an outpatient surgery center costs less than a hospital.
If you don’t have insurance
Stool-based tests cost much less than a colonoscopy and are a recommended screening option for many people. Community health centers and some state programs offer low-cost or free screening. If you’ve been diagnosed with cancer, ACA plans can’t turn you down or charge more; see does Obamacare cover cancer treatment and can cancer patients get health insurance.
Need a plan that covers preventive screenings? Compare quotes by ZIP code.
Frequently asked questions
Is a colonoscopy free with insurance?
A screening colonoscopy is free on ACA plans for adults 45 to 75 when you use in-network providers. A diagnostic colonoscopy may cost you.
What if they find a polyp during my screening?
On a private ACA plan, removing it during a screening colonoscopy shouldn’t add costs. On Medicare, you pay 15% coinsurance in 2026.
Does insurance cover a colonoscopy before 45?
If you’re at higher risk or have symptoms, your doctor can order one, but it may be billed as diagnostic, with cost-sharing.
Sources
This article is general information, not medical advice. Talk with your doctor about when and how to get screened. Last reviewed September 2026.