Medicare does cover certain breast cancer screenings and treatments.
Medicare Part A (hospital insurance) helps cover the costs associated with any inpatient hospital breast cancer treatment, such as surgery and chemotherapy. Medicare Part B (medical insurance) helps cover the costs of your outpatient care and annual mammograms.
Learn more about how Medicare helps to cover the costs associated with detecting and treating breast cancer.
Medicare Part B covers mammograms in the following ways:
Screening mammograms are covered in full by Medicare Part B, while women receiving a diagnostic mammogram will typically pay 20 percent of the Medicare-approved amount after meeting the Part B deductible.
The Medicare Part B deductible is $198 per year in 2020.
Medicare covers chemotherapy and radiation treatment of breast cancer in different ways, depending on whether you are a hospital inpatient or if you receive treatment in an outpatient setting.
Be sure to ask your doctor how Medicare will cover your chemotherapy treatments so that you have a good understanding of your potential costs.
Medicare Part B may provide some coverage for certain drugs taken for cancer, such as anti-nausea drugs used for symptoms of chemotherapy.
If Medicare Part B covers drugs you use to treat breast cancer or to alleviate nausea related to chemotherapy, you will pay 20 percent of the Medicare-approved amount for the drug.
If you receive prescription drug coverage through a Medicare Part D prescription drug plan or a Medicare Advantage plan that offers prescription drug coverage, your plan may provide additional coverage for your cancer drugs.
Be sure to check with your plan provider for detailed coverage information.
Medicare covers many medically necessary surgical procedures. If you have a mastectomy and are admitted for an inpatient hospital stay, Medicare Part A will help cover your hospital costs.
As with other covered items and services, your Medicare Part A and Part B deductibles and coinsurance apply.
Medicare Part A and Part B will cover some of the costs associated with clinical research studies for patients wanting to test a new breast cancer drug or treatment.
Some of the covered costs include office visits, tests and screenings required for program acceptance. Your Medicare Part B or Part A deductible and coinsurance may apply, depending on the setting in which the study takes place.
Medicare Advantage plans (Medicare Part C) are required to offer all of the same benefits that are covered by Original Medicare, combined into a single plan.
This means that the breast cancer screenings, treatments and drugs listed above are covered by Medicare Advantage plans in the same way that they are covered by Medicare Part A and Part B.
Some Medicare Advantage plans may also offer coverage for potentially more breast cancer drug costs than what Original Medicare covers.
Two out of every three cases of invasive breast cancer occur in women over the age of 55.1 And breast cancer accounts for the second-highest number of cancer-related deaths for U.S. women, behind only lung cancer.2
Don’t let your breast cancer screenings and treatment go without adequate medical attention and insurance coverage.
If you want to learn more about how a Medicare Advantage plan could help offer the benefits you need, call to speak with a licensed insurance agent today or compare plans online, with no obligation to enroll.
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