Does Medicare Cover Cancer Treatment?
- December 9, 2021
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.
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How does Medicare cover cancer treatment?
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
- Care received in a skilled nursing facility after you’ve been in the hospital for at least three days receiving related care
- Certain home health services related to your treatment
- Blood services
- Hospice care
- 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
- Outpatient radiation treatments
- Doctor appointments
- Outpatient surgeries and procedures
- Diagnostic testing
- Certain preventive services
- 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 limit
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.
Medicare Advantage plans cover cancer treatment
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 plans that help cover cancer treatment and cancer drugs
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About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
