Lung cancer is often found late, when it is harder to treat. But it does not have to be that way. A simple scan, or lung cancer screening, can catch lung cancer early, sometimes before a person has any symptoms at all.
The problem is that many people do not know they qualify for this scan. Others are not sure how to ask their doctor about it, or worry about what it might cost.
Lung cancer remains one of the leading causes of cancer death in the United States.¹ Early detection through screening can lower the risk of dying from lung cancer by finding it before it spreads.²
In this guide, we will break down who should get screened, what the screening involves, what your insurance may cover, and the exact steps to take to get the care you need.
Why Lung Cancer Screening Matters
Lung cancer often does not cause symptoms until it has already spread. By the time a person notices a cough that will not go away, chest pain, or trouble breathing, the cancer may be harder to treat.
Screening changes that. A low-dose CT scan can find small changes in the lungs years before symptoms show up. Finding lung cancer early gives doctors more treatment options and gives people living with the condition a better chance at survival.³
Screening does not mean something is already wrong. It means catching a problem early, while it is still easier to manage.
Who Should Get Screened
Lung cancer screening is not for everyone. It is recommended for people who have a higher risk of developing lung cancer because of their smoking history.
The U.S. Preventive Services Task Force (USPSTF) recommends yearly lung cancer screening with a low-dose CT scan for adults who meet all three of these:⁴
- Are between 50 and 80 years old
- Have a 20 pack-year smoking history (this means smoking an average of one pack a day for 20 years, or two packs a day for 10 years, and so on)
- Currently smoke, or have quit within the past 15 years
Screening can usually stop once a person has not smoked for 15 years, or if a health problem would make it hard to have lung surgery or treatment.⁴
If you are not sure whether your smoking history qualifies, your doctor can help you figure out your pack-year total.
What Happens During a Lung Cancer Screening
The recommended screening test is called a low-dose CT scan (sometimes written as LDCT). Here is what to expect:⁵
- The scan takes only a few minutes.
- You lie on a table that slides into a CT machine.
- There are no needles and no medication involved.
- The scan uses a lower amount of radiation than a standard CT scan.
Most people can go back to their normal day right after the scan. Results are usually ready within a few days, and your doctor will go over what they mean and whether any follow-up is needed.
What Insurance May Cover For Lung Cancer Screening
Because lung cancer screening is considered preventive care, many insurance plans are required to cover it at no cost to you.⁶
Under federal guidance, most private health plans and Marketplace plans must cover a yearly low-dose CT scan without a copay or coinsurance, even if you have not met your deductible yet, as long as you meet the USPSTF eligibility criteria.⁶
This means if you qualify based on your age and smoking history, your scan may be fully covered.
What Medicare Covers For Lung Cancer Screening
Medicare covers an annual low-dose CT lung cancer screening for people who meet the eligibility criteria, with no coinsurance or Part B deductible, as long as the provider accepts assignment.⁷
To qualify under Medicare, you generally need to:⁷
- Be 50 to 80 years old
- Have no signs or symptoms of lung cancer
- Have a 20 pack-year smoking history
- Currently smoke or have quit within the last 15 years
- Get a written order from your doctor after a shared decision-making visit
That last step matters. Medicare requires a conversation with your doctor about the benefits and risks of screening before your first scan.
What Medicaid May Cover For Lung Cancer Screening
Medicaid coverage for lung cancer screening can vary by state and eligibility group. Most state Medicaid programs cover low-dose CT screening for people who meet the same age and smoking history criteria used by Medicare and private insurance, but the exact rules and any required paperwork can differ.⁸
|
Insurance Type
|
Who Qualifies
|
What's Typically Covered
|
|---|---|---|
|
Private / Marketplace Plans |
Ages 50–80, 20 pack-year history, current smoker or quit within 15 years |
Annual low-dose CT scan at no cost |
|
Medicare Part B |
Same criteria, plus a shared decision-making visit with a doctor |
Annual low-dose CT scan with no coinsurance or deductible |
|
Medicaid |
Varies by state; often mirrors Medicare/USPSTF criteria |
Varies by state program |
7 Steps To Get Screened While Getting Insurance Support
Knowing screening exists is one thing. Getting it scheduled and covered is another. Use these steps to move from “I heard about this” to “I have an appointment.”
Step 1: Find Out If You Qualify Add up your smoking history in pack-years and check your age. If you are between 50 and 80 and have a 20 pack-year history, you likely qualify.
Step 2: Talk To Your Doctor Tell your doctor you want to be screened for lung cancer. Ask them to document your smoking history and refer you for a low-dose CT scan.
Step 3: Ask About the Shared Decision-Making Visit If you have Medicare, ask your doctor about the required counseling visit. This visit is also covered and is a required step before your first scan.
Step 4: Confirm Your Plan Type Check whether you have employer-sponsored insurance, a Marketplace plan, Medicaid, or Medicare. Your insurance card should have a member services number on the back.
Step 5: Call And Ask About “Lung Cancer Screening” By Name When you call your insurance plan, ask specifically:
- “Is a low-dose CT lung cancer screening covered under my plan?”
- “Do I need a referral or prior authorization?”
- “Is there a copay or coinsurance?”
- “Which imaging centers are in-network for this scan?”
Step 6: Schedule At An In-Network Facility Ask your doctor’s office to refer you to an imaging center that is in-network for your plan. This helps avoid surprise bills.
Step 7: Ask About Follow-Up Care If your scan finds something that needs a closer look, ask what follow-up tests are covered and what the next steps would be.
Self-Advocacy Language For Readers
If you want to ask about lung cancer screening and want your insurance to help pay for it, try using these words:
- “I have a smoking history and I am between 50 and 80. Can you tell me if I qualify for a covered lung cancer screening?”
- “I would like a referral for a low-dose CT lung cancer screening.”
- “Can you tell me if this scan will be covered at no cost under my plan?”
- “I have Medicare. Can we do the shared decision-making visit so I can get my first scan scheduled?”
- “Is there an in-network imaging center you recommend for this screening?”
How the NOWINCLUDED Community Can Help You
Getting screened for lung cancer should not feel confusing or out of reach. It is prevention, and it is a powerful step toward protecting your health.
No one should have to figure it out alone. Inside the NOWINCLUDED app, you can find trusted, culturally aware health education that helps turn confusing health decisions into clearer next steps.
Use this guide to talk with your doctor, ask your insurance the right questions, and take the next step toward getting screened.
Frequently Asked Questions
Q: Who should get a lung cancer screening?
A: Adults ages 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years should talk to their doctor about screening.
Q: What test is used to screen for lung cancer?
A: A low-dose CT scan (LDCT) is the recommended test. It is quick, does not use needles, and uses a lower amount of radiation than a standard CT scan.
Q: Does insurance cover lung cancer screening?
A: Most private health plans, Marketplace plans, and Medicare cover an annual low-dose CT scan at no cost for people who meet the eligibility criteria.
Q: Do I need a referral for lung cancer screening?
A: Many plans require a doctor’s referral, and Medicare requires a shared decision-making visit before the first scan. Check with your insurance plan for specific rules.
Q: How often should I be screened?
A: Screening is generally recommended once a year for people who continue to meet the eligibility criteria.
References
- CDC. (2024, September 12). Lung Cancer Statistics. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/lung-cancer/statistics/index.html
- CDC. (2024, September 12). What Is Lung Cancer Screening?. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/lung-cancer/screening/index.html
- American Cancer Society. (2023, October 25). Can Lung Cancer Be Found Early?. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/detection.html
- U.S. Preventive Services Task Force. (2021, March 9). Lung Cancer: Screening. Retrieved from USPSTF: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
- National Cancer Institute. (2023). Lung Cancer Screening (PDQ)–Patient Version. Retrieved from National Cancer Institute: https://www.cancer.gov/types/lung/patient/lung-screening-pdq
- HealthCare.gov. Preventive Health Services. Retrieved from HealthCare.gov: https://www.healthcare.gov/coverage/preventive-care-benefits/
- Medicare.gov. Lung Cancer Screenings. Retrieved from Medicare.gov: https://www.medicare.gov/coverage/lung-cancer-screenings
- Medicaid.gov. Preventive Services. Retrieved from Medicaid.gov: https://www.medicaid.gov/medicaid/benefits/preventive-services/index.html
