New Insurance Guidelines Cover Lung Cancer Screening Test

sticky-note-lung-cancer-screeningDid you know that lung cancer is the second most common cancer in both men and women? Did you also know that according to the American Cancer Society, lung cancer is the leading cause of cancer death among men and women. Each year, more people die of lung cancer than of colon, breast and prostate cancers combined. This is true because lung cancer is typically already more advanced when someone seeks medical attention for already existing symptoms. This makes early diagnosis crucial, as it provides the best chance for effective treatment options and better prognosis.

In June 2011, the New England Journal of Medicine published a landmark study which found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with a low-dose CT scan, instead of the standard chest X-ray. Low-dose CT scans (sometimes called spiral or helical CT scans) are the most effective tool in detecting lung cancer in patients at higher risk and with no symptoms.

Insurance Coverage for Qualified Patients

Most people know that smoking is one of the leading causes of lung cancer, with more than 80 percent of all cases involving current or former smokers. However, in the past, most insurance companies would not cover the cost of a CT scan to screen for lung cancer.

One of the direct impacts of the study was that it changed insurance coverage and reimbursements. Today, both private (commercial) insurers along with Medicare and Medicaid now cover the cost of a low-dose CT scanning for lung cancer for current and former smokers who fit predetermined criteria. There are variances, but in general the eligibility criteria are:

  • Age 55- to 77-years old
  • A smoking history of an average of a pack a day for 30 years or more
  • Current or former smoker (quit within the last 15 years)
  • If a current smoker: focus on importance of quitting and options for smoking cessation

Lung Cancer Screening at UMass Memorial Health Care

UMass Memorial Health Care has a system-wide lung cancer screening program available for current and former smokers. We offer lung screening CT scans at four different locations, and each facility is certified by the American College of Radiology as a Designated Lung Screening Center.

UMass Memorial Medical Center – 

Memorial Campus


119 Belmont Street, Worcester Monday – Friday, 7 am to 7 pm
UMass Memorial – Clinton Hospital 201 Highland Street, Clinton Monday – Friday, 7 am to 5 pm
UMass Memorial – HealthAlliance Hospital

Leominster Campus

60 Hospital Road, Leominster Monday – Friday, 7 am to 7 pm
UMass Memorial – Marlborough Hospital 157 Union Street, Marlborough Monday – Friday, 7 am to 7 pm

Saturday, 7 am to 4 pm


An Integrated Team Focused on Patient Care

When potential lung cancer is detected on a chest CT scan, a multidisciplinary lung cancer specialty team from interventional pulmonology, thoracic radiology and thoracic surgery meet to discuss the best treatment plan. UMass Memorial provides exceptional medicine with the comfort and convenience of care close to home.

For More Information and Scheduling a CT Scan

If you or a loved one are interested in learning more about lung cancer screening, the first step is to talk with your primary care doctor. All patients must have a physician referral for a lung cancer screening, and prior authorization is also needed from your insurance carrier. If you don’t have a physician, we will be happy to assist you in locating a doctor, and to obtain permission from your insurance company. For more information, call 855-UMASS-MD.

  2 comments for “New Insurance Guidelines Cover Lung Cancer Screening Test

  1. Anonymous
    December 18, 2016 at 1:42 am

    I am interested in a screening and encouraged to hear this is now available. I am a long- time smoker, although now just a minimal smoker. Never thought I would “catch” the habit, but alas I did. I have a great GP who has consistently offered support tools but I still haven’t quite made it to complete cessation. I’m greatly improved but not done.

    • December 19, 2016 at 9:27 am

      Thanks for reaching out. Just call 855-UMASS-MD to get started. Best of luck.

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