High Risk Individuals in Tennessee Should Get Screened for Lung Cancer

Coverage with No Cost Sharing will be Available to Many at High Risk Starting January 1, 2015

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NASHVILLE TN (12/29/2014)(readMedia)-- For the first time ever, starting January 1, individuals who are at high risk for developing lung cancer may be eligible for screening at no out of pocket cost. In Tennessee this includes most people with private insurance, individuals who are enrolled in their state health insurance marketplaces, and people enrolled in state Medicaid expansion who will be eligible for early detection screening without cost to them.

Patients considered to be high risk and potentially eligible for screening are 55 through 80 years of age; have a 30 pack-year history of smoking (this means 1 pack a day for 30 years, 2 packs a day for 15 years, etc.); and are a current smoker, or have quit within the last 15 years. Screening people at high risk has the potential to save more than 13,000 lives a year across the U.S.

"This is important news for many people at high risk of developing lung cancer. With screening becoming available to many at no out-of-pocket cost, many more people in Tennessee who should be screened can be," said Barry Gottschalk, president and CEO of the American Lung Association serving Tennessee. "The American Lung Association recommends that anyone who meets the high risk criteria should talk to their doctor about screening and check with their health insurance provider to see if their coverage includes screening."

Individuals who are enrolled in state health marketplace plans, enrolled in Medicaid-expansion programs and those with non-grandfathered private insurance plans who meet the screening criteria will have insurance coverage for screening without co-payments or other barriers starting January 1, 2015 or the beginning of their next plan year.

The American Lung Association has created the attached chart to help explain lung cancer screening coverage. The Lung Association also created the attached checklist for individuals to use when calling their insurance companies to determine if they are eligible for screening with no cost.

The American Lung Association also provides many free resources for lung cancer patients and their caregivers. Patients can determine if they are candidates for lung cancer screening through our online tool, lungcancerscreeningsaveslives.org.

Additional resources include Facing Lung Cancer: Support from Day One (http://www.mylungcancersupport.org/), a comprehensive online resource with interactive features that offers education and support to people living with lung cancer and their loved ones.

The Lung Connection (http://connection.lung.org/) is an online community where individuals living with lung disease and their caregivers can discuss how lung disease affects their lives and share experiences with peers.

Medicare, which provides health care insurance for most Americans over the age of 65, is in the midst of a separate National Coverage Determination process to determine coverage for lung cancer screening among its beneficiaries. A final coverage announcement from CMS is expected for Medicare patients in February.

Lung cancer is the leading cause of cancer death for both men and women in the United States. The five-year survival rate for lung cancer patients is only 17.8 percent. An annual low-dose screening test for individuals at high risk has the potential to dramatically improve lung cancer survival rates by finding the disease at an earlier, more treatable stage. The USPSTF estimates that if everyone who is at high risk is screened, there will be a 14 percent reduction in lung cancer deaths in the United States.

To increase awareness about lung cancer – from the importance of screening to treatment and support options – in May, the American Lung Association launched LUNG FORCE (www.lungforce.org), our national movement focused on fighting lung cancer in women.

Despite being the #1 cancer killer of women, only one percent of women say it's on their radar, according to our inaugural Women's Lung Health Barometer. LUNG FORCE is seeking to right this wrong: it's about education, uniting women to make a difference and inspiring America to take action against the devastating disease that is lung cancer.

"The most important risk factor for lung cancer is smoking, and the best thing people can do to reduce their risk is to stop smoking or never start," advises Gottschalk. "The American Lung Association has been helping people quit smoking for over 40 years. We believe anyone can quit and we have the tools and resources to help smokers quit for good."

The American Lung Association has helped more than one million people quit smoking through its Freedom From Smoking® (www.ffsonline.org) program and its Lung Helpline at 1-800-LUNGUSA. Information on screening and other lung cancer risk factors including exposure to secondhand smoke, radon, air pollution and other hazardous materials, can be found on the American Lung Association's website at www.lung.org.