Is Cologuard covered by my insurance? How can I find out?

The following plans cover Cologuard:

NATIONAL COVERAGE

  • Aetna Medicare Advantage
  • Anthem Blue Cross & Blue Shield

MID-ATLANTIC

  • CareFirst Blue Cross & Blue Shield
  • Horizon Blue Cross & Blue Shield of New Jersey (Medicare Advantage)
  • Johns Hopkins Employee Health Plan
  • Optima Health (Medicare Advantage)
  • Oxford Health Plans, a UnitedHealthcare Co. (NJ only)

MIDWEST

  • The Alliance
  • Blue Cross and Blue Shield of Illinois (Medicare Advantage)
  • Blue Cross & Blue Shield of Minnesota (Medicare Advantage)
  • Dean Health Plan
  • Group Health Cooperative of South Central Wisconsin
  • The Ohio State University Health Plan
  • Physicians Plus
  • Prevea360 Health Plan
  • Priority Health
  • Security Health Plan
  • Unity Health Plan
  • UPMC Health (Medicare Advantage)

NORTHEAST

  • Blue Cross & Blue Shield of Massachusetts 
  • Blue Cross & Blue Shield of Rhode Island
  • Excellus Blue Cross & Blue Shield
  • Tufts Health Plan
  • Univera Healthcare

SOUTH

  • HealthChoice/Orlando Health
  • Rosen Medical Center

WEST

  • Access Medical Group, Inc. – HMO
  • Anthem Blue Cross California - PPO
  • Blue Cross & Blue Shield of Arizona (Medicare Advantage)
  • Brown & Toland Physicians – HMO
  • Facey Medial Group – HMO
  • Meritage Medical Network – HMO
  • PacificSource Health Plans
  • Premier Care IPA – HMO
  • Providence Health Plan
  • SanSum Clinic - HMO
  • SelectHealth Advantage
  • Seoul Medical Group – HMO 

Even if your insurer covers Cologuard, your deductible, co-pay or out of pocket costs may vary according to your specific plan’s benefits. For details, please call your plan provider. Please note that although this list is updated frequently, it is subject to change.

We are seeking to have Cologuard covered by plans not listed here as soon as possible. In the meantime, please call your insurer to verify your specific benefits. You can let them know Cologuard is billed under CPT code 81528.