Medicare 2026

Medicare for Current and Former Smokers: Lung Scans, an Aneurysm Check and Quit Help

If you smoke now or used to, Medicare includes several preventive services built with you in mind. A yearly low-dose CT lung scan, a one-time ultrasound to check for an abdominal aortic aneurysm, and counseling to help you quit are all part of Part B — and when the rules are met and your provider accepts assignment, they cost you nothing. Here is a plain-English guide to what is covered, who qualifies, and how to make the most of it.

The yearly lung cancer screening

Part B covers one low-dose CT (LDCT) lung cancer scan each year for people who meet all of these conditions:

• Age 50 to 77
• No signs or symptoms of lung cancer
• Currently smoke, or quit within the last 15 years
• A smoking history of at least 20 "pack years" — an average of one pack (20 cigarettes) per day for 20 years, or the equivalent
• A written order from your provider

In February 2022, CMS broadened eligibility, lowering the starting age from 55 to 50 and cutting the required smoking history from 30 pack-years to 20. That change brought screening within reach for many more people.

Before your first scan, you need a "shared decision-making" visit with your provider. It is a conversation about the benefits and risks of screening — including the chance of false alarms and follow-up tests — and whether it is the right choice for you. If your provider accepts assignment, both that visit and the screening itself cost you nothing.

Important distinction: a screening is for people without symptoms. If your provider orders a CT because of a specific concern — a cough, chest pain, or an abnormal finding — that is a diagnostic scan, not a screening. For diagnostic imaging in a doctor's office or independent testing facility, you pay the Part B deductible ($283 in 2026) and then 20% of the Medicare-approved amount. In a hospital outpatient setting, you also owe a hospital copayment, which can be more than 20% of the approved amount. Ask ahead of time which category your scan falls under so you are not surprised by a bill.

The one-time abdominal aortic aneurysm ultrasound

Part B covers a one-time screening ultrasound for an abdominal aortic aneurysm (AAA) — a weakening in the body's largest artery that often causes no warning signs. You qualify with a provider's referral if you have a family history of AAA, or if you are a man aged 65 to 75 who has smoked at least 100 cigarettes in your lifetime. If your provider accepts assignment, there is no cost. It is quick and painless, and it is easy to miss — many eligible people have never heard of it. Ask your provider whether this screening is appropriate for you.

Help to quit — on Medicare's dime

Part B covers up to 8 tobacco-cessation counseling sessions in any 12-month period at no cost when your provider accepts assignment. CMS describes this as two quit attempts a year, each including up to four intermediate or intensive sessions. Counseling can be delivered by telehealth, which makes it easier to fit into a busy week or to use from home. Prescription medicines that help with quitting may be covered under your Part D drug plan; coverage and cost-sharing vary by plan, so check your plan's formulary.

The Welcome to Medicare visit

New to Medicare? The Welcome to Medicare preventive visit includes a review of risk factors for substance use — including tobacco and alcohol — and a referral to treatment if needed. It is a good moment to put a quit plan on the table and to line up screenings you qualify for.

A quick note on Part D for 2027

Prescription drug costs are getting more predictable. In 2027, the Part D out-of-pocket cap rises to $2,400 (it is $2,100 in 2026). The most any Part D plan may charge as a deductible in 2027 is $700. The national base beneficiary premium — used to calculate the late-enrollment penalty — is $41.33 for 2027; actual plan premiums are set plan by plan. Annual (Open) Enrollment runs October 15 through December 7, 2026, with choices taking effect January 1, 2027. The Social Security Administration announced a 3.6% cost-of-living adjustment for 2027 benefits. The 2027 Part B standard premium and deductible, and the IRMAA income brackets, will be announced by CMS in the fall.

If you have Medicaid or Extra Help

Since 2025, people with Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare paired with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also enroll in an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Original Medicare + Medigap, or Medicare Advantage?

Both paths cover the preventive services above. Original Medicare with a Medigap policy and a stand-alone Part D plan offers broad provider access nationwide and predictable supplemental cost-sharing, but with separate premiums. Medicare Advantage bundles coverage, often including drugs and extras, typically with network rules and prior authorization. Neither is "better" — it depends on your providers, medicines, budget, and preferences.

Where to go next

For official rules, screening details, and plan comparisons, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.