COVERAGE
Cost and coverage for the Cologuard® and Cologuard Plus® tests
The same easy ordering and broad coverage you're used to 1
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Your most prescribed CRC screening option:
Eligible patients will get the latest test covered by their insurance to ensure uninterrupted access.
Most insured and eligible patients pay $0 for the Cologuard or Cologuard Plus tests.1*
Use the tool below to search your patients’ insurance plans and see which version of the Cologuard test is currently available.
Search Insurance Providers
Insurance provider not found
Sorry, but your insurance may be out of network. Please call 1-866-267-2322 (Billing Enterprise) for assistance.
Have questions about patient access for the Cologuard or Cologuard Plus tests? Contact Customer Care at 1-844-870-8870 for support.
What in-network means
In-network means a health plan has contracted with Exact Sciences Laboratories as part of its preferred lab network. If a patient meets the plan’s clinical criteria, their test may be covered.
Please note that Exact Sciences cannot guarantee a patient's insurance coverage or eligibility.* Coverage and network limitations vary by insurer. To confirm, we recommend the patient contact their insurance provider to understand:
- What the insurer will cover
- Any patient responsibility or out-of-pocket costs
- Any required documentation prior to screening with the Cologuard test
* Some insurers may be considered in-network with Exact Sciences Laboratories, but restrict public use of their name or logo. If you are unsure about a patient's insurer status, please contact the insurer directly.
> 96%
Nationwide, over 96% of all Cologuard or Cologuard Plus patients have no anticipated out-of-pocket costs1*
Insurance coverage
Eligible patients who are actively enrolled in any state Medicaid program can access the Cologuard test. No payment will be expected from the patient unless the plan requires a co-pay.2†
Follow-up colonoscopy coverage
There is no cost sharing for colonoscopy following a positive Cologuard result. A colonoscopy following a positive Cologuard result is still considered a screening colonoscopy.2,4
January 2022
The federal government issued guidance making it clear that a colonoscopy after a positive noninvasive CRC screening test should be considered part of the screening process.2,4‡
2023 Policy Changes
Positive results from a noninvasive stool-based test, including the Cologuard test, qualify for coverage of follow-up colonoscopy with no cost sharing.2,4‡
As of 2023, Affordable Care Act (ACA) and Centers for Medicare & Medicaid Services (CMS) guidance requires coverage to encourage CRC screening by reducing financial barriers.2,4
Exact Sciences is committed to helping eligible patients access and afford CRC screening
Insurance support:
- Verification of benefits, as requested
- Patient-assisted insurance appeals
Financial support programs:
- Flexible payment plans
- Financial assistance program, based on eligibility
Customer Care:
- Available to providers and patients
- Available at Cologuard.com or by phone at 1-844-870-8870, every day, 6 AM to 10 PM CT
Cologuard ordering
Order the Cologuard test the way that best fits your practice
Cost & Coverage FAQs
Nationwide, most eligible patients aged 45 and older have no anticipated out-of-pocket costs for screening with the Cologuard Plus test.1*
You can use the Insurance Lookup Tool to search your patients’ insurance plans and see which Cologuard test is currently available.
- Exact Sciences estimate based on historical patient billing. Rate of coverage varies by state and region. (95% of patients aged 45-49 pay no out-of-pocket costs. Exceptions for coverage may apply; only your patients’ insurers can confirm how the Cologuard test would be covered.1
- Data on file for coverage. Market Access. 2025. Exact Sciences Corporation. Madison, WI.
Patients can visit Cologuard.com or call Customer Care at 1-844-870-8870, every day, 6 AM to 10 PM CT, with any questions regarding the cost and coverage for the Cologuard test.
They can also utilize the Exact Sciences patient assistance program, which helps patients facing challenges with insurance coverage receive their Cologuard screening at no cost.
As of 2023, the Affordable Care Act and Centers for Medicare & Medicaid Services require a colonoscopy after a positive Cologuard result be covered without cost sharing. A colonoscopy following a positive Cologuard result is still considered a screening colonoscopy. Some exemptions may apply.1,2*
- For patients with traditional Medicare, a colonoscopy after a positive Cologuard result is still a screening colonoscopy based on updated Centers for Medicare & Medicaid Services regulations, effective January 1, 2023. Medicare does not apply cost sharing to screening colonoscopy. This update does not apply to commercial plans with exempted status.1,2
- CMS. FAQs about Affordable Care Act implementation part 51. Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act implementation. Centers for Medicare & Medicaid Services. January 10, 2022. Accessed October 9, 2025. https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FAQs-Part-51.pdf
- CMS. Calendar year (CY) 2023 Medicare physician fee schedule final rule. Centers for Medicare & Physician Services. November 1, 2022. Accessed October 9, 2025. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-final-rule
- Exact Sciences estimate based on historical patient billing as of August 2025. Exceptions for coverage may apply; only your patients’ insurers can confirm how the Cologuard test would be covered.1
- The Cologuard test is a preventive service for NY Medicaid and members have no financial responsibility.2
- For patients with traditional Medicare, a colonoscopy after a positive Cologuard result is still a screening colonoscopy based on updated Centers for Medicare & Medicaid Services regulations, effective January 1, 2023. Medicare does not apply cost sharing to screening colonoscopy. This update does not apply to commercial plans with exempted status.2,4