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Medicare Lung Cancer Screening for Early Detection

Medicare covers lung cancer screenings and counseling to help you stay healthy. The disease is treatable in its early stages.

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UPDATE: On Thursday, Feb. 10, 2022, the Centers for Medicare & Medicaid Services (CMS) announced expanded coverage for lung cancer screenings, saying this decision “improves health outcomes for people with lung cancer.” Click here for more details, and stay tuned to our blog and Senior Healthcare Direct on Facebook for further updates.

Lung cancer is the second-most common cancer in both men and women, and it’s most common in people ages 65 and older. In 2021, the American Cancer Society estimates lung cancer will kill more than 131,000 Americans.

The number of new lung cancer cases descreases as more people take action for early prevention, like making the choice to quit smoking. The decision to quit smoking can be the first and most important step a person can make toward lowering their risk of developing lung cancer. If caught early, lung cancer can be treatable . Those with small cell lung cancer in its early stages have cure rates up to 80% or 90%, according to Cancer.net.

To make sure you stay informed on your lung health, Medicare covers important resources, like lung cancer screening, counseling and shared decision-making.

Medicare Part B Covers Annual Lung Cancer Screening

Medicare Part B covers lung cancer screenings once a year using low-dose computed tomography. Beneficiaries must meet all five of these conditions to qualify for these screenings:

  • Be between the ages of 55 and 77

  • Have no signs or symptoms of lung cancer

  • Be a current smoker or have quit within the last 15 years

  • Averaged one pack per day for at least 20 years

  • Have a written order from your doctor

You may be eligible for this service if you meet all the criteria and your doctor accepts Medicare assignment.

It’s important to note that the criteria necessary for lung cancer screenings could change based on recommendations from the U.S. Preventive Services Task Force (USPSTF). Be sure to check with your Medicare plan or this American Lung Association page for the latest updates.

Other Lung Cancer Resources: Counseling and Shared Decision-Making

Prior to your first lung cancer screening, all beneficiaries must schedule a lung cancer screening counseling and shared decision-making appointment with your doctor.

During this appointment, you’ll talk about the benefits and the risks of a lung cancer screening to ensure that’s the right path for you. For example, risks might include the possibility of a false positive or concerns over radiation exposure.

Your doctor will counsel you on the impact of comorbidities, like COPD, to a lung cancer diagnosis. You’ll discuss the importance of cigarette smoking abstinence, and if you meet all the criteria, your doctor will write an order for a lung cancer screening.

For Medicare beneficiaries who may be eligible for a lung cancer screening, please call your primary care physician. Then, schedule your lung cancer screening counseling and shared decision-making visit.

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.