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Colonoscopy Bowel Preparation Covered by Insurance

Tuesday, May 3, 2016

The Affordable Care Act (ACA) recognizes a colonoscopy screening as part of the free preventive services to be covered in all health plans. Since the ACA went into effect, the language regarding what is covered has needed additional clarification.

Initially there were questions concerning insurance coverage for removal of polyps during a routine screening. The Departments of Labor, Health and Human Services and the Treasury released a statement in 2013 stating that polyp removal is an integral part of a colonoscopy. As such, the removal of a polyp during a routine screening would not incur any cost-sharing.

The Departments of Labor, Health and Human Services and the Treasury have once again provided clarification to another frequently debated question concerning bowel preparation and cost-sharing.

The statement released on April 20, 2016 states that the required preparation for a colonoscopy is an integral part of the procedure. The preparation medications are required to be prescribed by a health care provider and would be covered under the preventive colonoscopy with no cost-sharing.

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