Starting February 2015, Medicare will cover yearly screenings to detect lung cancer for certain people with Medicare who have been heavy smokers and have no symptoms of cancer. The service includes a yearly Low Dose Computed Tomography (LDCT also called low dose CT) chest scans. Before the first scan, you must have a visit with your physician, nurse practitioner, or physician’s assistant to discuss the benefits and risks of the scan. The provider will also advise you about the importance of quitting or avoiding smoking and provide information about smoking cessation services when appropriate. After the first scan, the written order for the scan can be provided during any visit with a health care provider. A separate counseling visit is not required.
To qualify for this benefit you must:
- Be age 55 to 77 and currently smoke or have quit smoking in the past 15 years;
- Have smoked an average of one pack per day for at least 30 years;
- Have no symptoms or signs of lung cancer; and
- Receive the chest scan at a qualified radiology facility.
Speak to your radiology facility to see if it is a Medicare-approved to perform this preventive scan.
If you have Original Medicare, there is no coinsurance or deductible for the lung cancer screening if you use providers who take assignment. Doctors and other health care providers who take assignment cannot charge you more than the Medicare approved amount.
If you have a Medicare Advantage Plan, your plan cannot charge you deductibles, copays, or coinsurances as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.