Does Medicare Cover Lung Cancer Screenings?

Medicare covers a free annual preventive lung cancer screening for beneficiaries who qualify. To receive a screening, you must meet strict criteria, undergo proper counseling on the pros and cons and get tested at a qualified center.

Rachel Christian, writer and researcher for RetireGuide
  • Written by
    Rachel Christian

    Rachel Christian

    Financial Writer and Certified Educator in Personal Finance

    Rachel Christian is a writer and researcher for RetireGuide. She covers annuities, Medicare, life insurance and other important retirement topics. Rachel is a member of the Association for Financial Counseling & Planning Education.

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  • Edited By
    Matt Mauney
    Matt Mauney, Senior Editor for RetireGuide

    Matt Mauney

    Financial Editor

    Matt Mauney is an award-winning journalist, editor, writer and content strategist with more than 15 years of professional experience working for nationally recognized newspapers and digital brands. He has contributed content for ChicagoTribune.com, LATimes.com, The Hill and the American Cancer Society, and he was part of the Orlando Sentinel digital staff that was named a Pulitzer Prize finalist in 2017.

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  • Published: March 22, 2021
  • Updated: November 15, 2022
  • 3 min read time
  • This page features 7 Cited Research Articles
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APA Christian, R. (2022, November 15). Does Medicare Cover Lung Cancer Screenings? RetireGuide.com. Retrieved December 5, 2022, from https://www.retireguide.com/medicare/services/preventive/lung-cancer-screenings/

MLA Christian, Rachel. "Does Medicare Cover Lung Cancer Screenings?" RetireGuide.com, 15 Nov 2022, https://www.retireguide.com/medicare/services/preventive/lung-cancer-screenings/.

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Understanding Medicare’s Coverage of Lung Cancer Screenings

Lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States.

In 2015, the U.S. Centers for Medicare & Medicaid Services began covering annual lung cancer screenings with low-dose computed tomography for beneficiaries with a history of heavy smoking.

Low-dose computed tomography is a chest CT scan, which looks for small early-stage cancers. It has less radiation exposure compared to a standard chest CT scan.

During the screening, you lie on a table and an X-ray machine uses a low amount of radiation to take images of your lungs. The scan only takes a few minutes.

According to the American Lung Association, screening can help to reduce the lung cancer death rate by up to 20%

While a low-dose computed tomography has its advantages, it also comes with downsides.

For example, while this scan reduces radiation exposure, image quality is also reduced. This can lead to an increase in false-positive results, or results that suggest a person has lung cancer when no cancer is present.

That’s why Medicare also covers lung cancer screening counseling with a shared decision-making visit so you can discuss the benefits and harms of screening with your doctor.

Tip
The best way to reduce your risk of lung cancer is to not smoke and avoid secondhand smoke. Lung cancer screenings are not a substitute for quitting smoking.
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Who Qualifies for a Lung Cancer Screening?

Medicare coverage only includes a yearly preventive lung cancer screening for high-risk beneficiaries.

You must meet certain criteria to receive this Medicare-covered service.

To qualify for a screening, all the following conditions must apply:
  • You are 50 to 77 years old.
  • You don’t have signs or symptoms of lung cancer.
  • You’re either a current smoker or have quit smoking within the last 15 years.
  • You have a tobacco smoking history of at least 20 years, where you smoked a pack of cigarettes each day on average.
  • You receive a written order from your doctor.

Prior to your preventive screening, you’ll meet with your doctor for a counseling and shared decision-making visit.

During this visit, you’ll discuss:
  • If you meet Medicare’s eligibility requirements for a lung cancer screening.
  • The benefits and harms of screening, including overdiagnosis, false-positive rates and total radiation exposure.
  • Counseling on the importance of annual lung cancer screenings.
  • Your ability or willingness to undergo treatment if cancer is detected.
  • The importance of remaining smoke-free if you’re a former smoker or quitting smoking if you’re a current smoker.
  • Information about tobacco cessation programs, if appropriate.

If a lung cancer screening is right for you, your doctor can refer you to a high-quality screening facility.

According to Harvard Medical School, you should try to schedule your screening at a center of excellence in lung cancer.

If your follow-up confirms cancer, it’s important to have a team of radiologists, surgeons and other medical professionals experienced in treating the disease.

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Cost of Lung Cancer Screening with Medicare

Lung cancer screenings are one of many preventive services covered by Medicare Part B.

Medicare Advantage plans, which are administered by private insurance companies that contract with the federal government, also cover lung cancer screenings for beneficiaries who qualify.

All coinsurance payments and deductibles are waived for yearly lung cancer screenings.

You will owe nothing for this service so long as you continue to meet eligibility requirements.

Last Modified: November 15, 2022

7 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022, September). Medicare & You 2023. Retrieved from https://www.medicare.gov/publications/10050-Medicare-and-You.pdf
  2. American Lung Association. (2021, November 12). Lung Cancer Key Findings. Retrieved from https://www.lung.org/research/state-of-lung-cancer/key-findings
  3. Centers for Disease Control & Prevention. (2020, September 22). Who Should Be Screened for Lung Cancer? Retrieved from https://www.cdc.gov/cancer/lung/basic_info/screening.htm
  4. American Lung Association. (2020, April 14). Medicare Coverage for Lung Cancer Screening Frequently Asked Questions. Retrieved from https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/saved-by-the-scan/resources/medicare-coverage-faq
  5. Harvard Medical School. (2015, January). Medicare covers lung cancer screening. Retrieved from https://www.health.harvard.edu/cancer/medicare-covers-lung-cancer-screening
  6. Centers for Medicare & Medicaid Services. (n.d.). Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N). Retrieved from https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&NCAId=274
  7. Medicare.gov. (n.d.). Lung cancer screenings. Retrieved from https://www.medicare.gov/coverage/lung-cancer-screenings