Lung cancer generally refers to cancer that forms in the various tissues of the lungs. Lung cancer screenings include an annual Low-Dose Computed Tomography (LDCT, also called low-dose CT) chest scan.
Medicare Part B covers an annual lung cancer screening and LDCT scan if all of the following apply:
- You are age 55-77
- You currently smoke or have quit smoking in the past 15 years
- You smoked or have smoked an average of one pack per day for at least 30 years
- You have no symptoms or signs of lung cancer
- And, you receive the screening and LDCT scan at a Medicare-approved radiology facility
Before your first screening and LDCT scan, you must have a visit with your primary care provider (PCP) to discuss the benefits and risks of the scan. Your PCP will also provide counseling on smoking risks and smoking cessation services when appropriate. After your first screening, a separate counseling visit is not required before receiving subsequent screenings.
If you qualify, Original Medicare covers lung cancer screenings at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover lung cancer screenings without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your screening, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.
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