Even though the American Cancer Society and the US Preventive Services Task Force lowered the recommended age to start colonoscopy screenings to 45 in 2018, few insurance carriers have extended their coverage to match. Aetna, the third largest health insurance company in the United States, is now covering colonoscopy screenings for average-risk patients starting at 45.
Previously, the recommended age to start screening colonoscopies in average-risk individuals was 50. Average risk means a patient does not have a family history of colon cancer, symptoms of colon cancer, or a part of other increased-risk groups.
Aetna is the first major insurer to roll out the new coverage across all plans. Blue Cross Blue Shield has been covering colonoscopies at age 45 on some plans. This includes plans from H-E-B, University of Texas System, and BCBS Federal Plan.
By lowering the age to 45, more people may be diagnosed earlier, when treatment is more effective. Colon polyps can also be found and removed long before they have the chance to become cancerous.
Though the recommendation is strong and will save lives, not all insurance companies have adjusted their coverage. Aetna and other large insurance companies that have already made the change can help pave the way for others to do the same.
Other insurance companies that provide coverage at age 45 include Cigna and United.
The key change from Aetna is in their “Routine Screening” section for Colorectal Cancer coverage.
Aetna now considers a colonoscopy as a colorectal cancer screening test as medically necessary for preventive services for average-risk members aged 45 years and older when recommended by their physician.
Medically necessary preventative care is usually covered at no cost to the patient. This exemption often means patients don’t have to worry about copays, deductibles, or coinsurance.
We recommend contacting your insurance company to confirm your coverage benefits. If they have not begun covering colonoscopies at age 45, it’s important to encourage them to review the recommendations from gastroenterologists, the American Cancer Society, and the USPSTF.
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Read more about colonoscopy screenings for colorectal cancer.
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