Lung Cancer Screening Insurance Checklist

Questions to Ask Your Insurance Company about Coverage for Lung Cancer Screening

Lung cancer screening means testing for lung cancer before a person has any symptoms.For those who meet the high risk-criteria, screening is covered by Medicare and most private insurance plans with no cost sharing. However, before you decide to get a lung cancer screening, it is important to know exactly what your insurance will cover. Use the questions below as a guide for your conversations with your insurance company.

On the back of your insurance card, there will be a phone number for you to call. You will likely be asked for your plan information and group ID.

  • Has my insurance company put together a website or a flyer on lung cancer screening coverage issues?
  • Do I need to go to my primary care provider/my doctor before I get screened to get a referral or determine if screening is appropriate for me?
  • What paperwork do I need to complete before, during or after that visit to ensure my screening is covered by insurance?
  • Do I need a referral or preauthorization?
    • If so, from whom?
    • Who must this referral or preauthorization be sent to?
    • Will my physician submit it or must I?
  • Is there a certain place (facility or center) I need to go to for my screening?
    • If the nearest facility is too far away from where I live, what do I do?
  • Will my insurance cover my travel expenses to the screening?
  • Are all the costs of the screening completely covered or will I be charged any out of pocket expenses?
    • Will I need to pay a facility fee?
    • Are there other out of pocket costs I will need to pay?
  • Who do I follow-up with after my screening?
  • Is my follow-up doctor's visit covered under my insurance?
    • If not, what are the expected out of pocket expenses?
  • What follow-up tests will I need if something is detected during screening and will my insurance cover those tests?
  • If my doctor recommends screening every year, will it be covered by my insurance?
  • Will my insurance cover counseling and medications that can help me quit smoking? What are my out of pocket expenses?

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