Does Medicare Cover Cancer Treatment?
Almost 1 out of 3 people in the United States will have cancer in their lifetime, according to the American Cancer Society. While that statistic may be concerning, the good news is that with cancer treatment, some types and stages of cancer have very good survival rates.
There are many options for cancer treatment. Medicare generally covers cancer treatment and other medically necessary services.
What are my options for cancer treatment?
According to the National Cancer Institute, there are many types of cancer treatment. Some types of cancer treatment are performed on an inpatient basis and some are performed on an outpatient basis. Many people have a combination of treatments. Cancer treatment can include:
- Surgery to remove cancer from your Surgery can remove an entire tumor, debulk a tumor, or ease cancer symptoms.
- Radiation therapy which uses high doses of radiation to kill cancer cells and shrink tumors. Radiation can be administered as external beam radiation or internal radiation therapy where the source of radiation is put inside your
- Chemotherapy, which uses prescription drugs to kill cancer cells. Chemotherapy can be given orally, intravenously (through a vein), by injection, or topically, as a cream that you rub onto your skin.
- Immunotherapy which helps your immune system fight cancer
- Targeted therapy that targets changes in cancer cells that allow them to grow
- Hormone therapy to treat breast and prostate cancers
- Precision medicine which treats patients based on a genetic understanding of their disease
Does Medicare cover cancer treatment?
Cancer treatment may involve outpatient care, inpatient care, and prescription drugs you take at home. The different parts of Medicare may cover different aspects of cancer treatment.
Medicare Part A (hospital insurance) generally covers cancer treatment you receive as an inpatient including:
- Inpatient hospital stays
- Skill nursing care in a skilled nursing facility
- Hospice care
- Blood if you need a blood transfusion
- Breast implants after a mastectomy if you receive them as an inpatient
Medicare Part B (medical insurance) generally covers cancer treatment you receive as an outpatient including:
- Doctor visits
- Chemotherapy drugs administered in an outpatient clinic or doctor office
- Radiation therapy given in an outpatient clinic
- Diagnostic tests like x-rays and CT scans
- Outpatient surgeries
Medicare Part D may cover prescription drugs used to treat cancer and cancer treatment side effects. According to the National Cancer Institute, during cancer treatment you may experience:
- Appetite loss
- Nausea and vomiting
- Sleep problems
and other problems as a result of cancer and cancer treatment. If you take prescription drugs at home to help alieve these side effects, you may need Medicare Part D to cover your medications. Medicare Part A and Part B generally don’t cover prescription drugs you take at home. You can get Medicare Part D coverage through a stand-alone plan to go alongside Original Medicare or through a Medicare Advantage plan with prescription drug coverage.
Even with Medicare coverage, you may have out-of-pocket costs associated with your cancer treatment. Medicare Supplement may cover some out-of-pocket costs associated with cancer treatments including:
- Your Medicare Part A coinsurance
- Your Medicare Part B coinsurance
- Skilled nursing facility care coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- And other Medicare out-of-pocket costs
Although Medicare covers many services related to cancer treatments, Medicare generally doesn’t cover some cancer-related services such as:
- Wigs for cancer patients
- Home health care if personal care (such as bathing and dressing) is all you need.
To find a Medicare plan that covers cancer treatment, enter your zip code on this page.