For people at average risk, a stool-based test done at home is one of the recommended ways to screen, from age 45. NYC's health department describes it plainly: you collect a sample with a kit, mail it to a lab, and it needs little or no preparation. If the result is not normal, you need a follow-up colonoscopy. It is for people who are not at high risk, and you repeat it every one to three years depending on the test.
That matters for cost, because all three state programs pay for the follow-up colonoscopy after a positive stool test for people who qualify, and federal rules require most insurance plans to cover it without cost sharing.
The Cancer Services Program gives free colorectal screening and follow-up testing to New Yorkers without insurance, or whose insurance costs could keep them from getting screened, who meet its income and age rules. People 45 and older at average risk get a FIT kit. The program pays for a colonoscopy as the first test only if a New York-licensed clinician documents that you are at increased or high risk. If a test finds something, follow-up testing is free for eligible people, with a case manager, and if cancer is found, some people can enroll in the Medicaid Cancer Treatment Program. Call 1-866-442-CANCER (1-866-442-2262), any time, in English or Spanish. Local numbers for each borough are in our free cancer screening guide.
In New York City you can also call 311 to be connected to a Health + Hospitals location and find out whether you qualify for low- or no-cost care. NYC Care, for New Yorkers who cannot get insurance, has sliding-scale fees starting at $0 and does not ask about immigration status: 646-NYC-CARE (646-692-2273).
NJCEED screens for colorectal cancer, along with breast, cervical and prostate cancer, for people with income at or below 250% of the federal poverty level who are uninsured or underinsured, and helps with follow-up and getting into treatment. Call 1-800-328-3838, then press 3. In Newark, the Rutgers / University Hospital SAVE program is at (973) 972-5207.
Connecticut's colorectal program cannot pay for the first screening test. It does pay for a no-cost follow-up colonoscopy after a positive screening test if you are 45 to 75, at or below 250% of the poverty level, and uninsured or on a plan with a deductible of $1,000 or more. Participating sites: Bridgeport Hospital (203-384-3392), Danbury Hospital (203-739-4770), Hartford Hospital (860-972-3078), Cornell Scott Hill Health Center in New Haven (203-503-3000) and the Fairhaven Federally Qualified Health Center in New Haven (203-777-7411, ext. 5011). The Department of Public Health line is 860-509-7804.
Community health centers can order a FIT test or refer you for a colonoscopy on a sliding scale. Most insurance plans cover colon cancer screening without a copay, and Medicaid covers it in most states. Our directory of free and charitable clinics lists centers by state. A self-pay telehealth consult is not billed to Medicaid, so confirm what your plan already covers before paying out of pocket. If you want a mail-in test now:
Everlywell
A FIT colon cancer screening test you take at home.
$41, FSA/HSA eligible
Order the FIT testMost plans cover colorectal screening at no cost to you. Federal rules go further for colonoscopy:
- Follow-up after a positive stool test: plans must cover the follow-up colonoscopy with no cost sharing, for plan years starting on or after May 31, 2022.
- What is included in a screening colonoscopy: no cost sharing for a required consultation beforehand, the bowel prep medication, anesthesia, polyp removal and the lab test on a removed polyp.
- Medicare: Part B covers a follow-up colonoscopy after a positive Medicare-covered stool or blood test, and you pay nothing if your provider accepts assignment. If a polyp or tissue is removed, you pay 15% of the Medicare-approved amount for the doctor, plus 15% coinsurance for the facility in a hospital outpatient department or surgery center. The Part B deductible does not apply.
If a plan bills you anyway, our insurance appeal guide walks through the steps.
Ask the hospital for financial assistance before the procedure, and ask whether the gastroenterologist and the anesthesiologist bill separately. Their bills may not be covered by the hospital's program.
Since October 20, 2024, New York law has limited what hospitals can charge eligible patients for emergency and medically necessary care, and every hospital uses the same application form. You are eligible with household income up to 400% of the federal poverty level if you are uninsured, underinsured, or have used up your benefits. Immigration status does not count, and your assets, such as a house or car, may not be considered. The minimum discounts:
- Below 200% of poverty: all charges waived.
- 200% to 300%: uninsured patients pay up to 10% of what Medicaid would have paid.
- 301% to 400%: uninsured patients pay up to 20% of what Medicaid would have paid.
You can apply at any point, even after a bill goes to collections, and you cannot be required to pay while your application is pending. Payment plans cannot exceed 5% of your gross monthly income, interest is capped at 2%, and hospitals may not sue patients earning up to 400% of poverty over unpaid bills. The law covers the hospital's own services: a doctor who works at the hospital but is not its employee may bill you separately. Questions go to HFAL@health.ny.gov.
Charity Care covers medically necessary inpatient and outpatient care at every New Jersey acute care hospital for residents who meet its income and asset rules. It is not insurance. Your share of the hospital bill depends on income:
- 200% of poverty or below: you pay nothing.
- 201% to 225%: 20%. 226% to 250%: 40%. 251% to 275%: 60%. 276% to 300%: 80%.
- Above 300%: the full bill, though between 200% and 300%, medical bills above 30% of your yearly income may qualify for help on the excess.
Asset limits are $7,500 for an individual and $15,000 for a family, and you can spend down the excess on the bill. The hospital screens you for Medicaid first. Apply at the hospital's business or admissions office, up to a year after the date of service, and expect a decision within 10 business days of a complete application. Private physician, anesthesiology and radiology reading fees are separate and may not be reduced. The state's Charity Care line is 1-866-588-5696.
Every Connecticut hospital has a financial assistance policy, so ask about it before your procedure. Separately, state law caps what a hospital can collect from an uninsured patient with income at or below 250% of poverty who has applied for and been denied Medicaid: no more than the hospital's cost of providing the care. That is a cap, not free care. Connecticut hospitals also may not report patients to credit agencies. The Community Health Center Association of Connecticut can connect you with a community health worker to sort out coverage: 860-667-7820 or ask@chcact.org.
Our hospital financial assistance guide covers every state's rules in more detail.
Frequently asked questions
Can I get a free colonoscopy in New York without insurance? ▼
The Cancer Services Program starts most people with a free at-home FIT test. It pays for a colonoscopy up front if a New York-licensed clinician says you are at high risk, and pays for follow-up testing, including a colonoscopy, if a screening finds something. Call 1-866-442-CANCER.
Does insurance pay for a colonoscopy after a positive FIT test? ▼
Federal rules require most plans to cover the follow-up colonoscopy with no cost sharing, for plan years starting on or after May 31, 2022. Medicare covers it too, though you pay coinsurance if a polyp is removed.
Will I get a separate bill from the anesthesiologist? ▼
Possibly. In New York, a doctor who works at the hospital but is not its employee may bill separately, and New Jersey's Charity Care may not reduce anesthesiology fees. Ask before the procedure who will bill you and whether each bill is covered.
Does Connecticut pay for colonoscopy? ▼
Connecticut's program pays for a no-cost follow-up colonoscopy after a positive screening test for people 45 to 75 who meet its income and insurance rules. It does not pay for the first screening test.
