Do Insurers Have to Pay for Colonoscopy Now?

Will a colonoscopy be covered under the new law? I read that preventive care services classified A and B by the U.S. Preventive Services Task Force would be covered at no charge. Colon cancer screening is listed as an “A,” but colonoscopy is an costly procedure, and there are lower-cost options available. — Joy Kind

The U.S. Preventive Services Task Force recommends three colorectal cancer screening tests for people between the ages of 50 and 75: colonoscopy, sigmoidoscopy and fecal occult blood tests.

If you’re on Medicare, the tests will be covered at no cost to you starting in January. Likewise, new private plans must begin covering colorectal cancer screenings without cost-sharing for plan years that begin after Oct. 1. Existing health plans, however, will be grandfathered in and won’t have to meet that requirement. Regulators haven’t yet determined how much a plan can change and still keep its grandfathered status.

Some cancer screenings that are recommended by the American Cancer Society — including virtual colonoscopy and the DNA stool test — do not get a thumbs-up from the Preventive Services Task Force, stated Stephen Finan, senior policy director for the American Cancer Society’s Cancer Action Network.

Similarly, while the society recommends that people at higher risk for cancer (because of family history or other reasons) be screened more frequently, the task force makes no such recommendation. In general, a colonoscopy would be recommended once every 10 years, a sigmoidoscopy every five years and a fecal occult blood test every year.

Currently 27 says and the District of Columbia require insurance coverage of colorectal cancer screening. The new federal requirements won’t pre-empt those say laws. “To the extent that say law is broader, that would apply,” stated Mr. Finan.

Have a question about the new health care law? Send it to health_feedback@nytimes.com.

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