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Health Care Reform:

Health Insurance & Affordable Care Act

Cancer Screening and Prevention Under Health Reform

Free Cancer Screening Tests continued...

Lung cancer. Lung cancer is the No. 1 cancer killer of both men and women in the U.S.

If you're 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 was new after the Affordable Care Act was signed into law on March 23, 2010.

Rules on Free Screening Tests

Here's what you should know about cancer screening tests:

Does everyone get a free screening? The Affordable Care Act requires cancer screening tests only from health plans that started on or after March 23, 2010. If your plan was in place before then, you should call your insurance company to see if you get free screening tests. Otherwise, you might need to meet your plan’s deductible or pay a copay or coinsurance at the time of your appointment.

Your state might require that private health plans and Medicaid offer free screenings. Call your state health department or Medicaid office to see what is covered. Medicare does cover cancer screenings free of charge.

Keep in mind, though, that screening tests are just for people who don’t have any symptoms. If you have symptoms and your doctor orders a colonoscopy, it is not free. If you have colon cancer and get a colonoscopy, it is not free either. In either of these cases, a colonoscopy is a diagnostic test, not a screening test.

Can I make an appointment just for the free screening? You can schedule a cancer screening by itself or as part of your annual checkup. For some screenings, you might need a separate visit to the doctor. Colonoscopy is one example. You can have others, like a Pap test, during a regular checkup.

Can anyone get a screening at any time? You must follow your health plan’s guidelines to get your preventive screening tests. For example, you have to be 50 or older to receive a colon cancer screening. If you have a high risk of colon cancer, you can get checked every 2 years no matter how old you are without having to share the cost with your health insurance plan. If you have an average risk, you can get free colonoscopy only once every 10 years without having to share its cost with your health insurance plan.

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