Does Medicare Cover Cancer Treatment?

Medicare Part A and Medicare Part B both cover medically necessary cancer treatment.

Medicare Advantage plans (Medicare Part C) also cover cancer treatment, and many Medicare Advantage plans offer prescription drug coverage.

Medicare Advantage plans come with an annual out-of-pocket spending limit, which means that you could pay less for potentially expensive out-of-pocket cancer treatment costs if you have a Medicare Advantage plan. Original Medicare (Part A and Part B) doesn't include a spending limit.

Doctor talking with her patient

Understanding how cancer is covered by Medicare

What you pay for your cancer treatment largely depends on the type of Medicare coverage you have, where you receive your care and how long you receive it.

Medicare Part A cancer treatment coverage

If you’re receiving inpatient care to treat your cancer, Medicare Part A will cover your treatment. You’re an inpatient if you’ve been admitted to the hospital or a skilled nursing facility.

Medicare Part A cancer treatment services may include, but may not be limited to:

  • Care received while an inpatient at the hospital
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  • Care received in a skilled nursing facility after you’ve been in the hospital for at least three days receiving related care
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  • Certain home health services related to your treatment
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  • Blood services
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  • Hospice care
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  • Certain inpatient clinical research costs

Medicare Part B cancer treatment coverage

If you’re receiving outpatient care to treat your cancer, Medicare Part B will cover aspects of your treatment. Part B also covers certain cancer screenings (depending on a person’s risk level for the cancer being screened) and outpatient services in a hospital.

Part B cancer treatment services may include, but aren’t limited to:

  • Outpatient chemotherapy, including intravenous or some oral treatments
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  • Outpatient radiation treatments
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  • Doctor appointments
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  • Outpatient surgeries and procedures
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  • Diagnostic testing
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  • Certain preventive services
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  • Certain outpatient clinical research costs

Medicare Part A and Part B have different out-of-pocket costs (deductibles, copayments and coinsurance) that you may be responsible for. Make sure you understand if you are considered an inpatient or an outpatient before receiving a particular treatment.

Medicare Advantage plans have an out-of-pocket spending max

If you have a Medicare Advantage plan, you may have different out-of-pocket costs, depending on the plan you select.

As mentioned above, Medicare Advantage plans provide all of the same benefits that are offered by Original Medicare. This means that Medicare Advantage plans cover cancer treatments, too.

Medicare Advantage plans also have an annual out-of-pocket limit that will cap your out-of-pocket spending. Original Medicare doesn’t have an out-of-pocket limit.

Medicare prescription drug costs for cancer patients

Medicare Part B may provide limited coverage for cancer medications (such as certain chemotherapy drugs), but it won’t cover many others.

You can receive prescription drug coverage through Medicare Part D — either through a standalone prescription drug plan to use with Original Medicare, or through a Medicare Advantage plan that offers Part D coverage.

Your Medicare Part D coverage may help cover other medications needed for your treatment that Part B doesn’t. This can include certain oral chemotherapy drugs, pain medication, anti-nausea medication, among others.1

Call a licensed insurance agent today

If want to learn more about a Medicare Advantage plan — or are ready to enroll — you can speak to a licensed insurance agent to compare Medicare Advantage plans that are available where you live.

Find Medicare Advantage plans that help cover cancer treatment

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Or call 1-800-557-6059 (TTY: 711) 24/7 to speak with a licensed insurance agent.

 

1 Centers for Medicare & Medicaid Services. Medicare Coverage of Cancer Treatment Services. (July 2017). https://www.medicare.gov/Pubs/pdf/11931-Cancer-Treatment-Services.pdf.

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