Screening at 45 benefits allies, as insurance companies adopt guidelines

On May 18, 2021, the United States Preventive Services Task Force (USPSTF) lowered the recommended colorectal cancer screening age for average-risk adults from 50 to 45 years old. The change made 20 million additional people eligible for preventive colorectal cancer screenings, most at no cost through insurance.

Jennifer Ziemer was one of them.

“My mother was diagnosed with stage IV colon cancer in March 2021,” Jennifer said. “I started looking at getting a colonoscopy a few months later.” 

But when Jennifer called her major insurance company, they told her they wouldn’t cover her preventive screening, even with her mother’s health history. 

“For three months, I called my insurance company, and each time they said no,” she said. “Even after the new lowered age announcement, my insurance company was still not covering it.”

Christin Sonneborn, a certified patient and family support navigator and insurance specialist with the Alliance, encouraged Jennifer to continue calling her insurance company as the Alliance and our advocates were also contacting them to have their policies updated. 

After another three months, Jennifer finally heard the good news from Christin — her colonoscopy would be covered.

Advocating for Change 

According to the Affordable Care Act, health insurance payers have until 2023 to implement the new guideline and cover screenings. In response, the Alliance launched a grassroots campaign and delivered an urgent message to payers: “Tomorrow can’t wait.” 

“Our allies executed about 800 advocacy actions,” said Ali Miller, Alliance’s Senior Director of Community Engagement. “They called payers directly as concerned members, posted on social media, and secured almost 200 television news stories across the country.” 

While volunteers advocated by telephone and airwaves, the National Colorectal Cancer Roundtable — of which the Alliance is a proud member  — assisted in sending a letter to 100 payers who had not announced coverage of the lower screening age, asking them to do so by March 1, 2022. More than 50 colleagues at NCIs, prominent nonprofits, and provider trade associations signed the letter. 

The Alliance tracked the screening coverage of most large payers and can confirm coverage for colorectal cancer screening starting at age 45 by the following:

• UnitedHealth Group
• Kaiser Foundation
• Anthem 
• Centene Corp
• Humana
• CVS Health (Aetna)
• Cigna Health
• Independence Health Group

“Now the largest payers cover screening at 45, and many young lives will be saved because of it,” Ali said. “There are also more payers out there, and the Alliance isn’t big enough to monitor all of them. If you or someone you know is having trouble getting their screening covered, remember our free Helpline. We have an insurance navigator ready to assist.”

Move Forward, Get Screened

One year later, the Alliance continues to ask its allies and the healthcare community to help advance its mission to end colorectal cancer in our lifetime — by spreading awareness and getting screened.  

“I scheduled my first colonoscopy right after my 45th birthday in December 2021,” Jennifer said. The results? No polyps. “This preventative procedure is worth it for peace of mind. I have encouraged my siblings and friends to get their colonoscopy done.” 

If you are 45 or older, now is the time to get screened. Colorectal cancer is the preventable cancer. Take this quiz to determine which screening method is best for you and your risk factors.