Medicare Part B covers a free lung cancer screening every 12 months. You can get a Low Dose Computed Tomography (LDCT) diagnostic screening of your lungs if you meet the eligibility requirements.
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Medicare Lung Cancer Screening Eligibility
Before your first lung cancer screening, you must schedule a “lung cancer screening counseling and shared decision-making” visit with your primary care physician (PCP). During your PCP visit, your physician will confirm your eligibility, counsel you on lung cancer screening, and assist you in making a decision.
The American Lung Association says your doctor must confirm you meet all the following high-risk conditions:
- Age 55 to 77
- No current signs or symptoms of lung cancer
- You have a tobacco smoking history of at least 30 “pack years” (an average of one pack (20 cigarettes) per day for 30 years).
- Current smoker or former smoker who quit within the last 15 years.
If you meet the above eligibility requirements, your doctor can provide you a written order for the LDCT lung screening. Furthermore, your doctor is required to counsel you on the benefits and risks of lung cancer screening.
Medicare Lung Cancer Screening Counseling
According to CMS.gov, your doctor or qualified non-physician practitioner may furnish your lung cancer screening counseling. For example, a physician assistant, nurse practitioner, or clinical nurse specialist can provide this counseling. The doctor will counsel you on the importance of follow-up annual lung cancer screenings.
Furthermore, you may learn about the risks of comorbidity – having two or more long-term medical conditions. For example, you may be diagnosed with lung cancer and have another chronic illness, such as Chronic Obstructive Pulmonary Disease (COPD). The practitioner will counsel former smokers on abstaining from smoking and counsel current smokers on quitting smoking. Moreover, Medicare covers up to 8 tobacco cessation counseling visits per year.
Your doctor will consult you on the benefits and harms of lung cancer screening. This consult includes the risks of overdiagnosis and radiation exposure. Overdiagnosis is a situation where you have a harmless cancer, but you want to treat it anyway. Furthermore, your doctor will warn you that a false-positive diagnosis could occur. After this consult, you and your doctor can decide whether a Medicare-covered lung cancer screening is right for you.
Medicare Part B Preventive Services
Discover more Medicare Part B preventive services, including free colorectal cancer screenings, vaccine shots, and telehealth counseling. Furthermore, find out how much Medicare Part B premium and deductible will increase in 2021.
Last Updated on January 25, 2021 by Brian Kondas