Cologuard does require a prescription from your doctor after a medical evaluation. You can see your primary physician or see a physician online to request a prescription for Cologuard. Speak to a Doctor Now
Full Answer
Does Medicare cover a ColoGuard test?
Medicare includes coverage for colorectal cancer screening, including a Cologuard kit under specific circumstances. A stool DNA test (Cologuard) will be covered by Medicare every 3 years for people 50 to 85 years of age who do not have symptoms of colorectal cancer and who do not have an increased risk of colorectal cancer.
What should I do if my ColoGuard test results are positive?
Exact Sciences continues to work with payers to expand coverage and access for patients 45-49. It is important that you fully complete your colon cancer screening. If you have a positive Cologuard test result, you should discuss it with your healthcare provider and have a follow-up colonoscopy.
How do I order Cologuard without a healthcare provider?
Even if you don’t have a healthcare provider or an upcoming appointment, you can still request Cologuard online through a telemedicine provider. If you’ve discussed Cologuard with your healthcare provider in the past and believe it may have been ordered for you, please call Exact Sciences Laboratories at 1-844-870-8870.
What is the ColoGuard test?
The Cologuard test is a stool DNA test that looks for microscopic blood in the stool and altered DNA. It’s performed using an at-home kit that includes a container for a stool sample.
Do I need a referral for cologuard?
Exact Science, (the only laboratory provider that offers Cologuard), is considered non-network for TRICARE Prime. Therefore, an approved referral is required for Prime beneficiaries prior to testing or Point of Service (POS) will apply.
Does Medicare cover a cologuard test?
Cologuard is covered by Medicare and Medicare Advantage with no co-pay or deductible for eligible patients ages 50-85.
How do I order cologuard as a provider?
Fill out this order form entirely and fax it to Exact Sciences at 1-844-870-8875. Quick start guide for ordering Cologuard through your EMR. Sign up to receive biweekly fax updates about your Cologuard orders and a summary of your patients due for rescreening.
Can cologuard be purchased over the counter?
Best Prescription-Only Option Cologuard is an at-home FIT-DNA test that can detect both blood in the stool and abnormal DNA that can come from colon polyps. It is a widely accepted, FDA-approved method of colorectal cancer screening. Cologuard is only available with a prescription.
How much does cologuard cost out-of-pocket?
The cost of Cologuard is around $500. Part of that cost may be covered by some insurances depending on your plan, co-pay, and deductible. Diagnostic testing is subject to deductibles and coinsurance. Screening colonoscopies are not subject to copays and deductibles and usually have no out-of-pocket costs for patients.
Is cologuard just as good as a colonoscopy?
The Cologuard test is designed to detect cancer not prevent it. Cologuard can only detect 42% of large polyps, while a colonoscopy can detect 95% of large polyps. When polyps are detected during a colonoscopy they are removed at the same time.
Does Cologuard require prior authorization?
There is no prior authorization for Cologuard required for members enrolled in Medicare Advantage or Non-Medicare plans who are 50-75 years of age in whom colorectal cancer preventive screening is indicated. 4. What preparation is needed by my patient? No preparation is required.
How long does it take to receive Cologuard kit?
How long does it take to receive the results? Your Cologuard test result will typically be delivered to your healthcare provider within two weeks of our lab receiving a sample.
Which is better Cologuard vs fit?
Effectiveness: Though it is often cited that Cologuard has a sensitivity of 92% compared with FIT's sensitivity of 74%, it is important to recognize that FIT is performed yearly and Cologuard every three years.
How can I do a colon test at home?
To do at-home colon cancer screening, you'll need a prescription from your doctor. You'll collect the sample at home with the prescribed kit, then mail it off to the prescribing doctor (or a lab). When the analysis is complete, your doctor will go over the results with you.
At what age is Cologuard covered by insurance?
Stool DNA test (Cologuard): Covered at no cost* for those age 50 to 85 as long as they are not at increased risk of colorectal cancer and don't have symptoms of colorectal cancer (no co-insurance or Part B deductible).
How can I test my stool at home?
The fecal immunochemical test (FIT) is the test of choice over the fecal occult blood test. This test can be done at home. For this test, you take a sample from your stool with a brush and dab it onto a special card. This test may be easier to do at home than the FOBT.
What is Cologuard?
Cologuard is an at-home test for signs of colon cancer, including blood in the stool and evidence of polyps. All you need to do is collect a stool...
Who is Cologuard intended for?
Cologuard is for people between the ages of 50-75 who are at average risk of developing colon cancer. False positives increase for those over the a...
How effective is Cologuard?
In a study of 10,000 people, Cologuard detected 92% of colon cancers and 42% of high-risk precancers. 13% of people received a false positive. Fals...
How much does Cologuard cost?
The cost of Cologuard is 100% covered, with no co-pay or other out of pocket costs, by Medicare and most private insurance companies for eligible p...
Do I need a prescription for Cologuard?
Cologuard does require a prescription from your doctor after a medical evaluation. You can see your primary physician or see a physician online to...
What is a Cologuard test?
The Cologuard test is a stool DNA test that looks for microscopic blood in the stool and altered DNA. It’s performed using an at-home kit that includes a container for a stool sample. That sample is then shipped to a lab for testing.
How accurate is Cologuard?
Cologuard has a 12% false positive rate, and that rate increases as people age. Cologuard is less accurate than a colonoscopy at detecting polyps of any size. A colonoscopy can detect 95% of large polyps and Cologuard only 42%.
What does it mean if a colonoscopy is positive?
If the Cologuard test is positive, it may mean that colon cancer or polyps are present. After a positive Cologuard test a colonoscopy is required for a definitive answer. The Cologuard test has a 12% false positive rate, which means 1 in 10 positive tests will incorrectly identify cancer or polyps.
How much does Cologuard cost?
The cost of Cologuard is around $500. Part of that cost may be covered by some insurances depending on your plan, co-pay, and deductible. Diagnostic testing is subject to deductibles and coinsurance. Screening colonoscopies are not subject to copays and deductibles and usually have no out of pocket costs for patients.
How many polyps does Cologuard detect?
Detecting and removing polyps is critical to colon cancer prevention, and Cologuard only detects large precancerous polyps 42% of the time. A colonoscopy detects the same polyps 95% of the time and they are removed during the same procedure.
What is the difference between a colonoscopy and a colonoguard?
The Cologuard test is designed to detect cancer not prevent it. Cologuard can only detect 42% of large polyps, while a colonoscopy can detect 95% of large polyps. When polyps are detected during a colonoscopy they are removed at the same time. If polyps are detected with Cologuard, ...
Is Cologuard a replacement for colonoscopy?
Cologuard is not designed to be a replacement for a colonoscopy, even though advertisements may suggest otherwise. 58% of the time, dangerous precancerous polyps are not detected with Cologuard, which is significantly less effective than a colonoscopy.
