Does Medicare Cover Lung Cancer Screening in 2026? Eligibility, Costs, and LDCT Coverage
"Learn 2026 Medicare lung cancer screening eligibility, LDCT coverage, $0 screening costs, and follow-up testing rules."
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| Illustration. A doctor explains cancer examination and treatment to a patient at a hospital. |
Yes. Medicare Part B covers annual lung cancer screening with a low-dose CT (LDCT) scan for eligible beneficiaries. If you meet Medicare’s requirements and your healthcare provider accepts Medicare assignment, you pay nothing for the covered screening.
Here is what Medicare beneficiaries need to know about lung cancer screening coverage in 2026, including eligibility requirements, out-of-pocket costs, and what happens if a scan reveals an abnormality.
What Does Medicare Cover for Lung Cancer Screening?
Medicare Part B (Medical Insurance) covers preventive lung cancer screening using low-dose computed tomography, commonly called LDCT.
LDCT uses specialized X-ray equipment to create detailed images of the lungs while exposing patients to less radiation than a standard chest CT scan. The test can help detect lung cancer before symptoms develop, when treatment may be more effective.
According to Medicare.gov’s lung cancer screening coverage guidelines, eligible beneficiaries can receive this screening once every 12 months.
Medicare’s coverage includes a counseling and shared decision-making visit before the first screening. During this visit, the healthcare provider reviews the patient’s eligibility, explains the potential benefits and harms of screening, and discusses whether the test is appropriate.
The screening is intended for people at increased risk of lung cancer because of their smoking history. It is not a routine screening benefit for everyone enrolled in Medicare.
Who Qualifies for Medicare-Covered Lung Cancer Screening?
To qualify for Medicare Part B coverage, you must meet all five eligibility requirements.
| Requirement | Medicare’s rule |
|---|---|
| Age | 50 through 77 years |
| Symptoms | No signs or symptoms of lung cancer |
| Smoking history | At least 20 pack-years |
| Smoking status | Currently smoke or quit within the past 15 years |
| Provider order | A healthcare provider must order the screening |
These requirements are established under the Centers for Medicare & Medicaid Services (CMS) National Coverage Determination for lung cancer screening. See the official CMS coverage policy.
1. You must be between ages 50 and 77
Medicare’s covered age range is narrower than some general lung cancer screening recommendations.
For Medicare coverage, you must be at least 50 and no older than 77 when meeting the applicable eligibility requirements.
The American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) recommend annual LDCT screening for certain high-risk adults through age 80. However, those clinical recommendations do not expand Medicare’s national coverage age limit.
Important: Someone who is 78, 79, or 80 may meet a clinical screening recommendation but fall outside Medicare’s standard national eligibility criteria for this preventive screening benefit.
2. You need a smoking history of at least 20 pack-years
Medicare requires a tobacco smoking history of at least 20 pack-years.
A pack-year measures the cumulative amount a person has smoked. One pack-year is equivalent to smoking an average of one pack of cigarettes per day for one year.
Examples include:
One pack a day for 20 years = 20 pack-years.
Two packs a day for 10 years = 20 pack-years.
Half a pack a day for 40 years = 20 pack-years.
If your smoking amount changed over time, the periods can be calculated separately and added together.
For a detailed explanation, see our guide to calculating pack-years for lung cancer screening.
3. You must currently smoke or have quit within the past 15 years
Medicare’s standard coverage rules include current smokers and former smokers who quit within the previous 15 years.
For example, a 65-year-old who quit smoking five years ago and has a 25 pack-year history may meet the age and smoking-related criteria, provided the other requirements are satisfied.
A person who quit more than 15 years ago does not meet Medicare’s standard smoking-status criterion, even if their lifetime smoking exposure was substantial.
This is an important distinction between Medicare coverage rules and the ACS guideline, which recommends annual screening for eligible adults ages 50–80 with at least 20 pack-years regardless of when they quit smoking.
4. You must not have symptoms of lung cancer
Medicare covers LDCT under this benefit as a preventive screening test for people who do not have signs or symptoms of lung cancer.
Symptoms such as a persistent or worsening cough, coughing up blood, unexplained weight loss, or persistent chest pain require medical evaluation. A clinician may recommend diagnostic testing based on the symptoms and clinical circumstances.
A diagnostic examination is different from preventive screening, and its Medicare coverage and cost-sharing rules may differ.
5. Your healthcare provider must order the test
You cannot assume that an LDCT scan will qualify for Medicare’s preventive benefit simply because you meet the age and smoking-history criteria.
A healthcare provider must order the screening. Before your first covered LDCT, you must also complete a counseling and shared decision-making visit that meets Medicare’s requirements.
During the visit, you and your provider should discuss:
Your age and smoking history.
The potential benefits and limitations of screening.
False-positive results and the possibility of additional testing.
Overdiagnosis and radiation exposure.
Whether your overall health would allow you to benefit from treatment if cancer were detected.
Smoking cessation support if you currently smoke.
How Much Does Lung Cancer Screening Cost With Medicare?
For eligible beneficiaries receiving a covered preventive LDCT screening, the out-of-pocket cost is $0 when the provider accepts Medicare assignment.
| Cost question | Medicare Part B coverage |
|---|---|
| Annual eligible LDCT screening | $0 with a provider who accepts assignment |
| First screening counseling visit | Covered when Medicare’s requirements are met |
| Part B deductible for the covered screening | Does not apply |
| Screening more frequently than Medicare allows | Additional costs may apply |
| Diagnostic CT or follow-up procedures | Different cost-sharing rules may apply |
Medicare.gov confirms that eligible beneficiaries pay nothing for covered lung cancer screening when their provider accepts assignment. You can review the current rules on the official Medicare coverage page.
Before scheduling, ask the imaging facility and ordering provider to confirm that the appointment is being billed as a Medicare-covered preventive LDCT screening.
This matters because a diagnostic chest CT, a screening performed outside the covered frequency, or another service that does not meet the coverage criteria may be billed differently.
Does Medicare Cover Follow-Up Testing if an LDCT Scan Is Abnormal?
Medicare may cover medically necessary follow-up testing when an LDCT scan identifies a suspicious nodule or another abnormality. However, the follow-up evaluation is not necessarily covered under the same no-cost preventive screening benefit.
Depending on the findings, a clinician may recommend additional imaging, specialist consultation, or a biopsy. Coverage and out-of-pocket costs depend on the service, medical necessity, provider, and applicable Medicare rules.
An abnormal screening result does not automatically mean that a patient has lung cancer. Many findings require further evaluation to determine whether they represent cancer or a noncancerous condition.
Patients should ask their healthcare provider what the next test is intended to establish and confirm the likely costs with the provider and Medicare before proceeding when circumstances allow.
Does Medicare Advantage Cover Lung Cancer Screening?
Medicare Advantage plans, also known as Medicare Part C, must cover Medicare-covered preventive services, including eligible lung cancer screening.
However, the way you access the service can differ from Original Medicare. A Medicare Advantage plan may have network requirements, prior authorization procedures, or other plan-specific administrative rules.
Before scheduling your scan, contact your plan or review its Evidence of Coverage to confirm:
Whether the imaging facility is in network.
Whether the ordering provider is in network.
Whether the plan requires prior authorization or other documentation.
Whether the screening meets the plan’s eligibility and frequency rules.
Do not assume that every facility offering LDCT participates in your plan.
What If You Qualify for Screening but Do Not Have Medicare?
If you are uninsured or have coverage that does not pay for the scan, the cost of LDCT varies by location, imaging facility, and what is included in the quoted price.
Ask whether the price covers only the scan or also the radiologist’s interpretation and any consultation. A quoted self-pay rate may not include every related service.
For a detailed cost discussion, read our guide to how much LDCT lung cancer screening costs without insurance in 2026.
If you have private insurance, check your plan’s preventive screening benefits and eligibility criteria. Coverage may differ from Medicare’s rules.
Why Annual Lung Cancer Screening Matters
Lung cancer often develops without noticeable symptoms in its early stages. For people at increased risk because of their smoking history, annual LDCT screening can help identify suspicious findings before symptoms appear.
Screening also has potential harms. False-positive findings can lead to additional scans or invasive procedures, and some detected cancers may never have caused symptoms during a person’s lifetime. LDCT also exposes patients to a small amount of radiation.
That is why screening decisions should consider not only age and smoking history but also overall health, personal preferences, and the ability to undergo appropriate treatment if cancer is found.
People who currently smoke should also be offered evidence-based help to quit. Lung cancer screening does not eliminate the risks associated with smoking and is not a substitute for smoking cessation.
How to Check Your Medicare Lung Cancer Screening Eligibility
Before scheduling an LDCT scan, use this checklist:
I am between 50 and 77 years old.
I have at least 20 pack-years of cigarette smoking.
I currently smoke or quit within the past 15 years.
I do not have signs or symptoms of lung cancer.
I have discussed screening with my healthcare provider and obtained an order.
If this is my first screening, I have completed the required counseling and shared decision-making visit.
I have confirmed that the provider and imaging facility can bill Medicare for the covered preventive screening.
If you are unsure how many pack-years you have accumulated, ask your healthcare provider to calculate your smoking history. Accurate documentation helps determine whether you meet Medicare’s coverage criteria.
Frequently Asked Questions
Does Medicare pay for a lung CT scan every year?
Yes. Medicare Part B covers lung cancer screening with LDCT once every 12 months for eligible beneficiaries who meet the program’s requirements.
Is lung cancer screening free with Medicare?
The covered preventive LDCT screening costs $0 when you meet Medicare’s eligibility and coverage rules and your provider accepts assignment. Diagnostic testing and other follow-up services may have different cost-sharing requirements.
Does Medicare cover lung cancer screening after age 77?
Medicare’s standard national coverage criteria for this preventive benefit extend through age 77. Although some clinical guidelines recommend screening through age 80, those guidelines do not automatically extend Medicare coverage.
Can I get screened if I quit smoking more than 15 years ago?
You do not meet Medicare’s standard smoking-status requirement if you quit more than 15 years ago. Discuss your individual risk and any symptoms with your healthcare provider.
Does Medicare cover a chest X-ray for lung cancer screening?
Medicare’s covered preventive lung cancer screening test is LDCT, not a routine chest X-ray. A chest X-ray is not an equivalent substitute for LDCT screening.
What happens if Medicare denies coverage?
Ask your provider or Medicare Advantage plan why the claim was denied. The issue may involve eligibility, documentation, frequency, coding, or plan requirements. If you believe the decision is incorrect, request a review and follow the applicable Medicare appeals process.
The Bottom Line
Medicare Part B covers annual low-dose CT lung cancer screening at no cost for eligible beneficiaries ages 50–77 who have at least 20 pack-years of smoking history, currently smoke or quit within the past 15 years, have no lung cancer symptoms, and receive an appropriate provider order. A required counseling and shared decision-making visit must take place before the first screening.
Because Medicare’s coverage rules differ from broader clinical screening recommendations, confirm your eligibility and billing arrangements before scheduling an appointment. If you have symptoms, seek medical evaluation rather than relying on a preventive screening appointment.
Medical disclaimer: This article is for informational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Coverage decisions depend on Medicare rules and individual circumstances. Confirm eligibility and costs with Medicare, your plan, and your healthcare provider.
Source review: October 11, 2026. Eligibility and coverage statements were checked against official Medicare.gov and CMS guidance, with screening recommendations cross-checked against the American Cancer Society and U.S. Preventive Services Task Force.
Official sources
Medicare.gov — Lung cancer screenings — coverage, eligibility, frequency, and costs.
CMS — National Coverage Determination 210.14 — national Medicare eligibility and counseling requirements.
American Cancer Society — Lung cancer screening guidelines — clinical screening recommendations.
USPSTF — Lung cancer screening recommendation — annual LDCT recommendation and clinical criteria.