Medicare

Does Medicare Cover Cancer Treatment?

It's been suggested that 33 percent of people in the U.S. may develop cancer in this lifetime. Does medicare cover cancer treatment? Find out here and get help.

People over 65 years old account for 60% of newly diagnosed cancer cases. Their risk of developing this disease is ten times higher than that of those under this age. 

Medicare is the preferred health insurance plan for Americans aged 65 and older, offering nearly 60 million individuals coverage. The program features several coverage options at different rates. Knowing which one to choose can be confusing, at the least.

If you have a family history of cancer, you may wonder what your options are regarding health insurance. Does Medicare cover cancer treatment? What about palliative care?

The answer is yes — Medicare does cover cancer treatment under certain circumstances. What you'll pay out of pocket depends on whether you have a Medicare Supplement or a Medicare Advantage plan for extra coverage.

Feeling confused? That's why we're here. Read on to learn more about Medicare and cancer treatment so you can make an informed decision.

Does Medicare Cover Cancer Treatment? Get the Facts Straight

Cancer treatment is very complex and requires constant adjustment. Depending on your needs, it may include chemotherapy, hormone therapy, radiation, surgery, and everything in between. The average cost for these services is around $150,000.

Medicare covers most options, except for holistic treatments. How much coverage you get depends on the type of plan.

With Medicare Part A, your insurance provider will pay a portion of the costs associated with cancer-related services. These include but are not limited to:

  • Inpatient hospital care
  • Hospice care
  • Home health care, such as physiotherapy
  • Surgically-implanted breast prostheses
  • Blood work

Medicare Part B covers most services and treatments provided on an outpatient basis. These may include diagnostic tests, mental health services, medical equipment, and more. 

It also pays for screening tests and other preventive services aimed at those at risk for cancer. If you have diabetes or kidney disease besides cancer, your insurance plan may cover nutritional counseling as well.

Take radiation therapy, for example.

Medicare Part A covers this service for hospitalized patients. If you prefer to stay home and go to a clinic for treatment, you'll need Medicare Part B. This plan will cover some of the costs of treatment in freestanding clinics.

Another option is to enroll in Medicare Advantage plans so that you pay money out of pocket. Unlike Parts A or B, this coverage has out-of-pocket maximums for cancer treatment. Part D also pays for some chemotherapy drugs.

Both Original Medicare (Parts A and B) and Medicare Advantage cover palliative care for cancer patients. However, Part A includes limited home health care.

What Medicare Doesn't Cover

As mentioned earlier, Medicare doesn't pay for dietary supplements and other holistic therapies. The coverage also excludes adult daycare, medical food, and long-term care in a nursing home.

Medicare Advantage plans offer the most comprehensive coverage. What you'll pay out-of-pocket depends on the type of insurance, coinsurance, deductibles, and other factors.

Be Prepared for the Unexpected

Still wondering, “Does Medicare cover cancer treatment?” As you see, the answer is yes, but you'll still have to pay out-of-pocket.

Consider speaking to a licensed insurance agent to understand your options and choose one that meets your needs. Cancer strikes when you least expect it, so make sure you have a backup plan.

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