Medicare Covers Lung Cancer Screening for Qualified Beneficiaries

Medicare Covers Lung Cancer Screening for Qualified Beneficiaries

Did you know lung cancer is the leading cause of cancer deaths for both men and women in the U.S.? In 2013 alone, 159,480 Americans died of lung cancer, which amounted to close to a third of all cancer deaths that year. Also, when lung cancer is detected early (and is still localized in the lungs), people have a 54% 5-year survival rate, yet only 15% of cases are detected in an early stage. If the cancer has already spread, the 5-year survival rate goes down to 4%. Lung cancer affects a growing number of beneficiaries each year and with such statistics showing the benefit of early detection, Medicare announced this February that it now covers lung cancer screening for qualified beneficiaries. The screenings use Low Dose Computed Tomography (LDCT) to scan the lungs.

Beneficiaries can qualify for this new annual lung cancer screening benefit if they:

  • Are between 55-77, and are either current smokers or have quit smoking within the last 15 years;
  • Have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years); and
  • Have a written order from a physician or qualified non-physician practitioner. This written order comes from a covered lung cancer screening and shared decision making visit where the practitioner determines the beneficiary’s eligibility and reviews the advantages and risks of lung cancer screening.

For more information on the new lung cancer screening benefit, see the Center for Medicare and Medicaid Services’ Lung Cancer Decision Memo. To learn more about lung cancer, the prevalence and incidence rates, the causes, gender and ethnic differences, survival rates and the statistics in this article, see the lung cancer fact sheet from the American Lung Cancer Society. See to learn more about Medicare’s other preventive benefits and screenings.

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.