Cologuard: Rx only Stool DNA Test

Information & Support for Patients

Next Steps for Cologuard

Now that your doctor has ordered Cologuard for you, here’s what happens next:

*You may receive a call or email from Exact Sciences Labs to confirm your mailing address and insurance information.

*We ship your kit directly to you.

*You collect your stool sample in the privacy of your own home.

*You return the kit via UPS prepaid shipping or pick-up, in the same box it arrived in.

*Your doctor contacts you with your results.

If you have any questions about completing the test, please call us at the number below.

Exact Sciences Patient Support 1-844-870-8878

Available 24 hours a day, 7 days a week.

Insurance

Your insurance plan may cover all or part of your Cologuard test; here’s a quick guide.

Medicare Covers Cologuard:

*Patients with Traditional Medicare and Medicare Advantage plans do not have any co-pays or deductible amounts.

*For Medicare Advantage patients, prior authorizations may apply. Please call your insurer to confirm.

Private Insurance Coverage varies by Plan:

*Depending on your insurer and specific plan, your out of pocket cost for Cologuard could range from $0 to $649*.

*We highly recommend that you call your insurer directly to confirm what they will pay, what they expect you to pay, and if you or your doctor need to file any paperwork (like a prior authorization) before you use the test. You can tell them Cologuard is billed under CPT code 81528.

Billing:

*After your complete your screening test, our specialists will seek payment from your insurer.

*You will get an Explanation of Benefits after your insurance provider reviews any claim, whether they approve or deny it. THIS IS NOT A BILL.

*If your insurer does not pay in full, the remaining balance will become your responsibility.

If you have more detailed questions about your specific plan, please call your insurer directly. For more information on insurance and billing, visit: cologuardtest.com/insurance.

*As of July 2016

For a step by step video on how to use Cologuard, visit:

cologuardtest.com/use

*Disclaimer: this information is taken directly from the Cologuard pamphlet. I have not used the service so I have no opinion of the program either yes or no to how it works. Please call them directly for more information.