COLOGUARD® AND COLOGUARD PLUSTM: INSURANCE AND COST
Get screened for colon cancer for $01
Whether you’ll receive the Cologuard or Cologuard Plus test depends on your health plan. Let’s see what is available to you. You also have an option to pay out-of-pocket for the Cologuard or Cologuard Plus test.
Most insured patients pay $01
Across the country, more than 96% of Cologuard patients have no out-of-pocket cost for screening.1
A number of national and regional insurers already pay for colon cancer screening. We’re committed to working with insurance companies to expand coverage and access for patients aged 45 and above.
Let’s check if you’re covered
Medicare
The Cologuard Plus test is available with no copay or deductible for eligible Medicare Part B members aged 45 to 85. If you have a Medicare Advantage plan, use the search tool below to see if you’re eligible to receive the Cologuard Plus test.
Medicaid
The Cologuard test is covered for eligible patients enrolled in any state Medicaid program. No payment is expected unless the plan requires a copay.* Use the search tool below to see if your Medicaid plan provides access to Cologuard Plus.
*The Cologuard test is a preventive service for NY Medicaid, and members have no financial responsibility.
Search insurance providers
Use the search tool below to find your insurance provider and see which test is available.
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Congrats!
Have questions about your access to the Cologuard or Cologuard Plus test? Don’t see your plan listed? Customer Care is ready to provide answers at 1-844-870-8870.
What in-network means
Simply put, it means that we’ve agreed with your insurer to be part of their lab network. Your health plan will then cover the cost of your test if you meet certain clinical criteria.
Please note that we cannot verify your insurance coverage or eligibility for you.† Some insurers have coverage and network limitations and exclusions. To be sure, please call your insurance provider to confirm:
- What they will pay
- What they expect you to pay
- Any required paperwork before using the test
The good news is that, for eligible out-of-network patients aged 45-75, the Cologuard test should be covered without a copay or deductible through the Affordable Care Act.
† Some insurers may be considered in-network with Exact Sciences Laboratories, but do not allow the use of their company name or logo on our website. If you are unsure of your insurer’s status, please contact them directly for more information.
Our patient assistance program
We believe everyone should have access to the best health care options. Our patient assistance program can help people who are facing challenges with their insurance coverage.
If your household is at or below 400 percent of the Federal Poverty Level (FPL), you might be able to receive Cologuard screening at no cost.2,3
When you apply to request a no-cost Cologuard test, you'll be asked to provide income documentation. If you qualify for other assistance programs, that may be enough to decide your eligibility for our program.4
Those programs include, but are not limited to:
- Medicaid3
- Supplemental Nutrition Assistance Program (SNAP)
- Supplemental Security Income (SSI)
- Home Energy Assistance Program
Have questions about our assistance program or would like to apply? Please call our Customer Care Center at 1-844-870-8870 and select “billing option”.
Frequently asked questions
You can request the Cologuard Plus test through your health care provider. Your insurance will determine which version of the test you will receive. You can also request your test by ordering with self-pay. To find out if your insurance covers the Cologuard Plus test, use our insurance lookup tool.
Across the country, more than 96% of the Cologuard test patients have no out-of-pocket cost for screening.1 A number of national and regional insurers already pay for colon cancer screening. Working with insurance companies is part of our commitment to expand coverage and access for patients aged 45 and above.
Medicaid
The Cologuard test is covered for eligible patients enrolled in any state Medicaid program. No payment is expected unless your plan requires a copay.* Use our search tool to see if your Medicaid plan provides access to the Cologuard Plus test.
Medicare
The Cologuard Plus test is available with no copay or deductible for eligible Medicare Part B members aged 45 to 85. If you have a Medicare Advantage plan, use our search tool to see if you’re eligible to receive the Cologuard Plus test.
* The Cologuard test is a preventive service for NY Medicaid, and members have no financial responsibility.
The self-pay price for the Cologuard Plus test is $790. This cost is eligible for reimbursement through FSA, HSA, or HRA accounts.
The Cologuard Plus test is covered by Medicare Part B, and coverage through other insurance plans is expanding. To check if it’s available under your plan, use our insurance lookup tool.