Does Medicare Cover Chemotherapy?
Medicare Part A and/or Part B typically cover chemotherapy for beneficiaries who have cancer and receive treatment from a doctor who accepts Medicare assignment.
Medicare Advantage (Part C) plans also cover chemotherapy for qualified beneficiaries. Most Medicare Advantage plans also cover prescription drugs, such as oral chemotherapy cancer drugs.
Original Medicare (Part A and Part B) does not typically cover prescription drugs.
How much does Medicare pay for cancer treatment?
If your chemotherapy services are covered under Medicare Part B, you typically pay 20 percent coinsurance of the Medicare-approved amount (after you meet your Part B deductible, which is $185 per year in 2019).
If you’re an inpatient and receive chemotherapy while in the hospital, your treatment may be covered by Medicare Part A rather than Part B.
The specific amount you’ll owe for inpatient chemotherapy may depend on type of inpatient facility, how long you stay and whether your doctor accepts assignment.
We recommend asking your health care provider for specific cost information.
Does Medicare cover chemotherapy pills?
Though prescription drugs are not covered by Medicare Part A or Medicare Part B (including some used during the course of cancer treatment), most Medicare Advantage plans offer prescription drug coverage.
Some of the prescription drugs that may be covered by a Medicare Advantage plan include:
- Medications for chemotherapy only available to be taken by mouth
- Anti-nausea drugs
- Pain medication and other prescription drugs used in the course of your cancer treatment
Many Medicare Advantage plans also offer benefits such as dental, vision and hearing coverage, which Original Medicare doesn’t cover.
By law, every Medicare Advantage plan must provide the same level of coverage as Original Medicare. This means the chemotherapy services that are covered by Original Medicare will also be covered by Medicare Advantage.
Plan benefits and availability can vary based on where you live.
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