Yes, Medicare covers lung cancer screening at no cost to you if you meet specific eligibility requirements. The screening uses a low-dose computed tomography (CT) scan and is covered under Medicare Part B as a preventive service. To qualify, you must fall within a defined age range, have a significant smoking history, and get an order from your health care provider.
Who Qualifies for Coverage
Medicare will pay for your lung cancer screening if you meet all five of these conditions:
- Age: You’re between 50 and 77 years old.
- No symptoms: You don’t currently have signs or symptoms of lung cancer.
- Smoking status: You’re either a current smoker or you quit within the last 15 years.
- Smoking history: You have at least a 20 pack-year history, meaning you averaged one pack (20 cigarettes) per day for 20 years. Smoking two packs a day for 10 years also counts, since the math works the same way.
- Provider order: Your doctor or other health care provider writes an order for the screening.
Every condition must be met. If you’re 78, or if you quit smoking 16 years ago, you won’t qualify for coverage even if the other criteria fit. It’s worth noting that the U.S. Preventive Services Task Force recommends screening through age 80, but Medicare’s current coverage stops at 77.
What the Screening Costs
Because lung cancer screening is classified as a preventive service under Part B, Medicare covers it with no out-of-pocket cost to you. You pay no deductible and no coinsurance for the CT scan itself, as long as you meet the eligibility criteria and the screening is coded as a preventive service. If the scan leads to follow-up diagnostic imaging or biopsies, those additional tests are not part of the free screening benefit and would be subject to your normal Part B cost-sharing.
The Required Counseling Visit
Before your first screening, Medicare requires a shared decision-making visit with your provider. This isn’t just a formality. During this visit, your provider will walk you through the potential benefits and risks of screening using a patient decision aid, which is a standardized tool that lays out the information in a balanced way. The goal is to make sure you understand what the screening can and can’t do before you agree to it.
This visit also addresses tobacco use. If you’re still smoking, your provider is expected to connect you with cessation resources. If you’ve already quit, the conversation may focus on staying smoke-free. The counseling visit is billable to Medicare separately from the scan, and it’s covered as part of the screening benefit.
How Often You Can Get Screened
Medicare covers one low-dose CT scan per year. This annual screening continues as long as you still meet all the eligibility requirements. You’ll need a new order from your provider each year, and your eligibility will be reassessed at each visit.
When Coverage Stops
Your Medicare coverage for lung cancer screening ends when any of the eligibility criteria no longer apply. The most common reasons:
- You turn 78. Coverage cuts off after age 77.
- You hit 15 years since quitting. If you quit smoking and 15 years pass without a cigarette, you’re no longer eligible.
- You develop symptoms. If you start showing signs of lung cancer, any imaging your doctor orders shifts from “screening” to “diagnostic,” which is covered differently under Part B (with standard cost-sharing).
- A health condition limits your life expectancy. The USPSTF recommends stopping screening if you develop a condition that substantially limits your life expectancy or your ability to undergo lung surgery, since the purpose of catching cancer early is to treat it.
How Pack-Years Are Calculated
The 20 pack-year threshold trips up some people, but the math is straightforward. Multiply the number of packs you smoked per day by the number of years you smoked. One pack a day for 20 years equals 20 pack-years. Two packs a day for 10 years also equals 20. Half a pack a day for 40 years gets you there too. If your smoking varied over the decades, your provider can help you estimate a reasonable total.
Your provider relies on your self-reported history for this calculation. There’s no blood test or medical record that proves exactly how much you smoked, so be as accurate as you can. Underestimating could mean you don’t qualify for a screening that could catch cancer early.
Medicare Advantage Plans
If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your plan is required to cover at least the same preventive services that Original Medicare covers. That means lung cancer screening with the same eligibility criteria must be included. However, your plan may have its own network requirements, so you might need to use a specific imaging center or get a referral. Check with your plan before scheduling to avoid unexpected bills.
Why This Screening Matters
Low-dose CT scans can detect lung cancer at earlier stages, when treatment is more likely to succeed. Lung cancer is the leading cause of cancer death in the United States, partly because it’s often caught late, after symptoms like a persistent cough or unexplained weight loss appear. By the time symptoms show up, the cancer has frequently spread beyond the lungs. Annual screening in high-risk individuals catches tumors when they’re smaller and more treatable, which is why Medicare covers it as a preventive benefit rather than leaving it as a diagnostic expense.