Medicare covers yearly screenings for lung cancer for people with a high risk of developing lung cancer. The eligibility guidelines were expanded in 2022.

Original Medicare (parts A and B) and Medicare Advantage plans cover an annual lung cancer screening for people without lung cancer symptoms who meet the eligibility criteria.

Starting in 2022, Medicare made lung cancer screenings available to more people to support early diagnosis.

For people with symptoms that may indicate lung cancer, diagnostic imaging is not considered part of a yearly screening but part of a diagnosis.

This article covers the screening guidelines, what to expect from a screening, and the costs you can expect to pay with Medicare.

Medicare’s eligibility guidelines for yearly lung cancer screenings generally align with those from the U.S. Preventive Services Task Force. To be eligible for yearly screenings through Medicare, you must meet the following criteria:

  • be 50 to 77 years old
  • have no symptoms of lung cancer
  • current smoker or former smoker who quit within the last 15 years
  • tobacco history of at least 20 “pack years,” which is the equivalent of one pack of 20 cigarettes daily for 20 years
  • a doctor or other healthcare professional orders the screening

Regarding lung cancer screening guidelines, a “pack year” is an average based on smoking one pack per day for 20 years. Having 20 pack years can also translate to having smoked two packs a day for 10 years or half a pack a day for 40 years.

If you meet the lung cancer screening guidelines and visit a healthcare professional who accepts assignment for the screening, Medicare covers the full cost.

If a healthcare professional accepts assignment, this means they accept the cost that Medicare covers for a lung cancer screening. You will be responsible for paying the difference if they charge more than this amount.

Depending on your screening results, you may need additional testing to determine a diagnosis. There is also a chance of a false positive. If you require additional tests, you will be responsible for your portion of their costs. This can include:

  • your Part B deductible
  • 20% of the cost of additional appointments or tests after reaching your deductible
  • your Part A deductible if you require a hospital stay (due to an open lung biopsy, for instance)

Lung cancer screenings use low dose computed tomography, also called a low dose CT scan. A low dose CT scan uses imaging to identify masses or nodules in the lungs before they get large enough to cause symptoms.

A low dose CT scan for lung cancer typically takes less than 1 minute. A technician usually has you lie still on a table or hospital bed that slides in and out of the scanner. They may ask you to hold your breath for a short while.

A specialist reads the test, and a member of your care team will contact you with the results once they are available. If you have electronic records, you may see your results online before your physician has read the test.

While low dose CT scan screenings increase early detection and reduce deaths from lung cancer, sometimes these tests may detect benign masses or deliver false positives.

If your test results are positive, a doctor will likely recommend additional follow-up tests, some of which may be invasive.

Medicare covers approved lung cancer treatments administered by a healthcare professional or facility that accepts Medicare. Treatment can include:

Medicare also covers the cost of other services you require as part of your cancer treatment. This may include:

  • additional testing and monitoring
  • doctors’ appointments
  • procedures
  • infused medications
  • some oral cancer medications, which may be covered by Medicare Part B or D, if you have a Part D plan

You will be responsible for deductibles and coinsurance costs. A Medicare supplement, or Medigap, plan may help cover out-of-pocket expenses associated with your treatment.

If you have a Medicare Advantage plan, it must cover at least what would be covered by Original Medicare. It may also cover additional services not covered by Medicare.

However, if you decide to pursue experimental or complementary treatments, keep in mind that Medicare does not usually cover them.

Medicare typically covers recommended cancer screenings.

Medicare covers the full cost of annual lung cancer screenings if you meet the eligibility criteria and receive the screening at a healthcare facility that accepts Medicare.

You may be eligible for yearly screenings if you have a high risk of developing lung cancer and do not have symptoms of lung cancer.

Lung cancer screenings support early detection and treatment of lung cancer, but there is also a chance of false positives. You may need additional testing to confirm a diagnosis if you receive a positive test.