Insurance Coverage for Lung Cancer Screening
Medicare covers the office visit with your provider for lung cancer screening shared decision making and yearly LDCT lung cancer screening, with no out-of-pocket costs for beneficiaries who meet Medicare coverage criteria (see the Who Should Think About Lung Cancer Screening? page).
According to the Affordable Care Act preventive service coverage rules, commercial health insurance plans and Medicaid Expansion plans must cover lung cancer screening with no out-of-pocket costs for people who meet all of the U.S. Preventive Services Task Force eligibility criteria (see the “Who Should Think About Lung Cancer Screening?” page).
Commercial insurance coverage rules for lung cancer screening can be different from plan to plan, for example, you may need prior authorization or your plan may not yet be covering the updated U.S. Preventive Services Task Force Criteria. And some private insurance plans are “grandfathered,” meaning they don’t have to follow the no out-of-pocket cost rule under the Affordable Care Act.
If you have questions about your insurance coverage, please call your health insurance plan.