Costs and Insurance Coverage for Cancer Screening
When you’re ready to get screened for cancer, it’s important to understand what costs your medical insurance covers for screening tests and whether you are responsible for any out-of-pocket costs.
Coverage for cancer screening is determined by certain federal and state laws, as well as the policies set by your insurance provider.
If you have limited or no insurance, you can find financial assistance for screening tests.
- What is considered a screening test?
- Are insurance companies required to pay for cancer screening tests?
- What screening tests will my insurance cover?
- Can I get a cancer screening if I don't have medical insurance?
- Can I get free or low-cost cancer screening?
- Questions to ask about costs and insurance coverage for cancer screening tests
What is considered a screening test?
Screening tests are used to find cancer in people who have no symptoms. The goal of having regular screening is to increase the chances of finding certain cancers early, when they are small, have not spread, and might be easier to treat successfully.
Screening tests are different from diagnostic tests. Diagnostic tests are done to find the cause of symptoms someone is having. Sometimes the same type of test, such as a mammogram or colonoscopy, can be used for both purposes. How the test is ordered by a health care provider (as either screening or diagnostic) affects how it is billed and what your insurance will cover. This is why it’s important to know the purpose of the test you are getting.
The screening tests recommended for you and when you need to get them might be different from other people. This is because your age, sex at birth, family history, and lifestyle affect your risk for developing cancer.
Are insurance companies required to pay for cancer screening tests?
The Affordable Care Act (ACA) requires both private insurers and Medicare to cover the costs of certain cancer screening tests. But, if a health plan was already in place before the ACA was passed (such as in grandfathered plans), it might not offer the same coverage. You can find out the date your insurance plan started and if your recommended screening tests are covered by contacting your health insurance company.
Many states also have laws to make sure private insurance companies, Medicaid, and other employee health plans pay for regular screening tests.
It’s important to know that insurers may follow different screening guidelines to determine which tests are covered. They may not match the American Cancer Society guidelines about which tests to get, when to get them, or who should get them.
What screening tests will my insurance cover?
Insurance coverage for cancer screening tests depends on the type of insurance you have. It is best to check your insurance provider’s portal or website. Or you can call them to know exactly what screening tests will be covered and if you can expect any out-of-pocket costs for screening.
Here are some examples of insurance plans and screening test coverage. Keep in mind there are other types of plans, such as employer-sponsored fully-insured plans, Marketplace plans, and others.
Self-insured plans
Self-insured (or self-funded) plans pay employee health care costs from their own funds, though they usually contract with another company to handle claims. You can find out if your health plan is self-insured by contacting your insurance provider or reading your Summary of Plan Benefits.
These plans are governed by the Affordable Care Act (ACA), so most are required to cover certain cancer screening tests with no out-of-pocket costs, such as co-pays or deductibles. Still, it’s important to check with your insurance to know exactly what’s covered, including any costs for related doctor visits or follow-up exams.
Before getting a screening test, ask your insurance company how much (if anything) you should expect to pay and whether costs could change based on what’s found during the test. This can help you avoid surprise bills.
Medicare
Medicare usually covers the following cancer screening tests in full:
- Cervical cancer screening tests
- Most colorectal cancer screening tests
- Breast cancer screening tests
- Lung cancer screening test
- Prostate cancer screening tests
However, sometimes you might have a co-pay or other costs related to a doctor’s visit. Costs can be different for each person depending on your Medicare health plan and whether your doctor accepts Medicare.
If you have questions about your costs, including deductibles or co-pays, it’s best to speak with your insurance provider. You can also learn more in Medicare Coverage for Cancer Prevention and Early Detection.
Medicaid
Medicaid coverage for cancer screening tests vary by state. It's best to check with your state Medicaid office to learn more about what services are provided for cancer screening tests.
Can I get a cancer screening if I don't have medical insurance?
If you need a screening test but don’t have health insurance, your local county or state health department may have programs available. To find yours, check the US Centers for Disease Control and Prevention (CDC) Health Department Directories or call 800-CDC-INFO (800-232-4636).
You may also qualify for benefits under the American Rescue Plan (ARP) Act. This law was created to address financial problems caused by the COVID-19 pandemic. It includes provisions to lower insurance costs and improve access to coverage.
- If you don’t have insurance: You may qualify for lower cost plans through health insurance marketplaces. Keep in mind there may be deadlines for signing up.
- If you currently have insurance through the marketplace: You may see lower premiums. In some cases, you may also be able to switch to a different plan.
- If you have lost your job: The law can cover 100% of the premiums for COBRA, which lets you keep your former employer’s health plan for a limited time.
For general information on health insurance, visit Understanding Health Insurance. You can also call our helpline at 1-800-227-2345.
Can I get free or low-cost cancer screening?
Options for free or low-cost cancer screening tests are available. Sometimes, hospitals or clinics might host free cancer screening events. Your local health department may host or offer resources to find facilities or events offering screening for free or little cost.
National Breast and Cervical Cancer Early Detection Program
All states are making cervical and breast cancer screening more available to women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This program provides breast and cervical cancer screening to people without health insurance for free or at very little cost. The NBCCEDP attempts to reach as many people in underserved communities as possible, including those who are older, without health insurance, and who are members of racial and ethnic minorities.
Though the program is run by each state, the Centers for Disease Control and Prevention (CDC) provides support to each state program.
Each state’s Department of Health has information on how to contact the nearest program participant. For more information on this program, you can also contact the CDC at 1-800-CDC-INFO (1-800-232-4636) or on the web at www.cdc.gov/cancer/nbccedp.
If cancer is detected during screening in this program, most states can now extend Medicaid benefits to cover the costs of treatment.
Questions to ask about costs and insurance coverage for cancer screening tests
Even with insurance, you might have to pay part of the cost for your screening tests. These out-of-pocket costs are the part your insurance doesn’t cover.
Here are some questions to ask your health insurance company to find out if they pay or reimburse you for most of your medical expenses.
- Are cancer screening tests covered in full? If not, what will my out-of-pocket costs be?
- Will my out-of-pocket costs change if I need follow-up visits or more tests after the screening?
- Are there any preferred doctors, hospitals, or testing facilities I should use for my screening tests?
- If I use any out-of-network doctors, hospitals, or testing facilities, what will my expected costs be?
- Do I need to get insurance approval (pre-approval or pre-certification) for any screening tests?
- Written by
- References
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
Centers for Disease Control and Prevention (CDC). National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Accessed at https://www.cdc.gov/cancer/nbccedp/about.htm on April 19, 2021.
HealthCare.gov. Affordable Care Act (ACA). Accessed at https://www.healthcare.gov/glossary/affordable-care-act/ on April 19, 2021.
HealthCare.gov. Medicaid and CHIP coverage. Accessed at https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/ on March 10, 2021.
HealthCare.gov. Preventive care benefits for women. Accessed at https://www.healthcare.gov/preventive-care-women/ on April 19, 2021.
Medicare.gov. Preventive & screening services. Accessed at https://www.medicare.gov/coverage/preventive-screening-services on April 19, 2021.
The White House. American Rescue Plan. Accessed at https://www.whitehouse.gov/american-rescue-plan/ on April 19, 2021.
U.S. Department of Health and Human Services. Fact Sheet: The American Rescue Plan: Reduces Health Care Costs, Expands Access to Insurance Coverage and Addresses Health Care Disparities. Last updated March 12, 2021. Accessed at https://www.hhs.gov/about/news/2021/03/12/fact-sheet-american-rescue-plan-reduces-health-care-costs-expands-access-insurance-coverage.html on April 19, 2021.
Last Revised: November 5, 2025
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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