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Everything you need to know about Medicare's new lung cancer screening coverage

Medicare's new coverage for lung cancer screenings begins in early 2015.
(From left) Tadashi Allen, MD, Teri Kast, CNS, and Abbie Begnaud, MD, are all members of the lung cancer screening team at University of Minnesota Medical Center.

The Centers for Medicare and Medicaid (CMS) announced on Monday, Nov. 10, that it will cover lung cancer screening costs for those who are eligible. Coverage for lung cancer screening begins in early 2015.

We spoke with University of Minnesota Health Pulmonologist and Critical Care Physician Abbie Begnaud, MD, a lung cancer specialist, to get the scoop on the new coverage standards and lung cancer screening procedures at University of Minnesota Medical Center.

Tell us about the announcement that came out on Nov. 10?
This is a draft decision, and officials may make some small changes when a final decision is confirmed in 90 days. Still, it is a critical step in ensuring that at-risk individuals receive the screening they need so we can catch cancer at its earliest stages. Currently, some private health insurers do cover the screening, but regardless of personal insurance coverage, eligible patients seen at University of Minnesota Medical Center can receive free and immediate screening through a special grant from A Breath of Hope Lung Foundation.

Learn more about the Medicare announcement.

How does this decision affect people in the Twin Cities area?

This announcement helps raise awareness of the importance of screening for lung cancer. With expanded coverage for Medicare and Medicaid patients, we anticipate that more people will step forward to get screened, which bolsters efforts to advance care for those with lung cancer.

While we look forward to helping more people, University of Minnesota Health Cancer Care recognized the importance of screening well before it was endorsed by CMS and we will continue to be a leader in lung cancer screening. Our screening program started in 2013 and is still the only one in the state of Minnesota designated a Center of Excellence by the Lung Cancer Alliance.

Medicare will also require high standards of the imaging centers performing the test and the radiologists interpreting the exam. The University of Minnesota Health lung cancer screening program meets these high standards.

Find out more about our lung cancer screening program.

Describe a typical lung cancer screening appointment?

Most patients will make the decision to undergo lung cancer screening along with their doctor at a regular office visit. Then, the screening appointment can be scheduled at the imaging center at University of Minnesota Medical Center. When a patient arrives for their screening appointment, he or she will not need to withhold eating or drinking beforehand, nor will they have to make any other special preparations.

The patient will check in and answer a few questions about their risk for lung cancer, including smoking history, medical history, family history and other environmental exposures. The exam itself is very fast—a matter of seconds—and requires a person to lay flat on a moving table while briefly holding their breath. Even people who tend to get claustrophobic tend to have no problem with this test because it goes quickly and doesn’t require a person to be completely enclosed in the scanner.

Once the exam is complete, patients can expect to receive results within one week. The doctor who ordered the patient’s test will also get the results. If we find something worrying, a member of our care team will call the patient immediately, in addition to sending results through the mail.

How do I know if I should be screened?
Lung cancer screening is recommended for current and former smokers based on age and smoking history. Below is a summary of people who should be screened, according to Medicare standards:

  • Men and women between the ages of 55 and 74*
  • Individuals who have smoked at least a pack of cigarettes a day for 30 or more years.
  • Current smokers or those who have quit within the past 15 years

*We believe screening is beneficial for those older than 74 years of age. Some private insurers may provide coverage for these screenings, or the procedure can be paid for out of pocket.