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Health Care Reform:

Health Insurance & Affordable Care Act

Cancer Screening and Prevention Under Health Reform

Free Cancer Screening Tests continued...

If you have Medicare, you won't be charged for Pap tests and pelvic exams. Medicaid also covers Pap tests, but the details vary from state to state.

Colon cancer. Nine out of 10 people survive long-term if their colon cancer is caught early. However, just 40% of colorectal cancers are found at that early stage. If the cancer spreads to nearby organs or lymph nodes, the 5-year survival rate goes down to 70%. If it spreads to distant organs, your survival rate drops to 12%.

Under the Affordable Care Act, private health plans must offer one of several different types of screening tests for colon cancer. After age 50, you can receive a fecal blood test, a sigmoidoscopy, or a colonoscopy without owing a copay or coinsurance. Again, this does not apply to grandfathered plans so be sure to check your plan's summary of benefits.

Medicare coverage also offers free colon cancer screening tests. It's possible, though, that you might have to pay copay for the doctor’s visit, anesthesia, or hospital visit.

What Medicaid will cover depends on which state you live in.

Lung cancer. Lung cancer is the number one cancer killer of both men and women in the U.S.

If you are a longtime smoker, you may be able to get free testing under new lung cancer screening guidelines. These have been proposed, but the federal government has not yet adopted them.

The test is a once-a-year, low-dose CT scan. You could get this screening if all of these are true for you:

  • You're 55 to 80 years old.
  • You have smoked one pack a day for 30 years. Or you have smoked two packs a day for 15 years.
  • You now smoke, or have quit in the past 15 years.

Screening would be seen as a preventive measure, just like cervical and colon cancer screening tests. Medicare and Medicaid also would offer free screenings. You would also be able to get it with a private plan that took effect after the Affordable Care Act was signed into law on March 23, 2010.

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