Insurance coverage of lung cancer screening

Click on the option that applies to you to see if lung cancer screening is covered by your health insurance.

Note: As US Preventive Services Task Force recommendations were updated on 9 March 2021, insurance coverage has yet to reflect these changes. Please contact your insurance providers to confirm whether lung cancer screening would be covered for you if you are: i) between 50 and 54 years old with a smoking history of more than 20 pack-years; or ii) between 55 and 80 years old with a smoking history of 20-29 pack-years.



Employer-sponsored plan

This is insurance that is provided for you through your employer, union or other professional association. You are eligible to be covered for the initial lung cancer screening if you:
  • are between 50 and 80 years old
  • have a smoking history of 20 pack-years (Click here to work out your pack-years)
  • have smoked within the last 15 years

If your plan is 'grandfathered' under the Affordable Care Act, it is not required to cover lung cancer screening. Check the documents of your plan and verify with your insurer about this.

Should there be cost-sharing?

No. You should not be charged a copay, a co-insurance or deductible for screening if you go to a provider who is in your network.


Will there be other costs?

There might be. Be sure to check with your insurance company what they are covering for the procedure.


State insurance marketplace plan

This is a plan that you enrolled in via healthcare.gov or a marketplace/exchange website set up by your state. You are eligible to be covered for the initial lung cancer screening if you:
  • are between 50 and 80 years old
  • have a smoking history of 20 pack-years (Click here to work out your pack-years)
  • have smoked within the last 15 years


Should there be cost-sharing?

No. You should not be charged a copay, a co-insurance or deductible for screening if you go to a provider who is in your network.


Will there be other costs?

There might be. Be sure to check with your insurance company what they are covering for the procedure.


Medicare

You are eligible to be covered for the initial lung cancer screening if you:
  • are between 50 and 77 years old
  • have a smoking history of 20 pack-years (Click here to work out your pack-years)
  • have smoked within the last 15 years
  • have no signs or symptoms (e.g., pain, weight loss, persistent coughing) of lung cancer


Should there be cost-sharing?

No. You should not be charged a copay, a co-insurance or deductible for screening if you go to a provider who is in your network.


Will there be other costs?

There might be. Be sure to check with your insurance company what they are covering for the procedure.


Medicaid

Coverage of lung cancer screening in Medicaid varies by state. We suggest that you contact your Medicaid provider and check if your plan covers lung cancer screening.


    Individual plan

    This is insurance that you buy directly from an insurer. You are eligible to be covered for the initial lung cancer screening if you:
    • are between 50 and 80 years old
    • have a smoking history of 20 pack-years (Click here to work out your pack-years)
    • have smoked within the last 15 years

    If your plan is 'grandfathered' under the Affordable Care Act, it is not required to cover lung cancer screening. Check the documents of your plan and verify with your insurer about this.

    Should there be cost-sharing?

    No. You should not be charged a copay, a co-insurance or deductible for screening if you go to a provider who is in your network.


    Will there be other costs?

    There might be. Be sure to check with your insurance company what they are covering for the procedure.


    Click here for the most up-to-date insurance coverage information from the American Lung Association.