Does Medicare Cover Chemotherapy? 5 Things to Know.

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People new to Medicare and recently diagnosed with cancer wonder about their coverage. In this Senior Affair article, Find out how Medicare covers chemotherapy.

1.8 million people are diagnosed with cancer each year. Breast cancer is the most common cancer affecting women more than men. 

With cancer being so common, you aren’t alone in wondering: does Medicare cover chemotherapy? What about other cancer treatments and cancer drugs? Wonder no longer because we’re answering those questions for you today.

Ready to learn more about Medicare cancer coverage? Then keep reading because this one’s for you.

Does Medicare Cover Chemotherapy?

Yes, Medicare does cover chemo! Whether you have Original Medicare or a private Medicare Advantage plan, you can get coverage for inpatient and outpatient chemo treatments.

Inpatient Chemotherapy

Original Medicare and Medicare Advantage Part A will cover chemotherapy treatments you receive in a hospital. However, you must meet your deductible before Medicare starts paying out. 

Outpatient Chemotherapy

Original Medicare and Medicare Advantage Part B will cover outpatient chemotherapy treatments if you have cancer.

Part B covers 80% of the cost of chemo treatments you get at a freestanding clinic or a doctor’s office. Treatments you receive in your home or another outpatient setting will require a copay. 

Part B also covers the chemo treatments you get at a skilled nursing facility. Medicare will only pay for 100 days of professional nursing facility chemo treatments per benefit period. You’ll have to pay out of pocket if you need chemo treatments for more than 100 days. 

Other Cancer Treatments Covered Under Medicare

Chemo isn’t the only approved technique for treating cancer. Radiation therapy and immunotherapy are also common today. 

Here’s what you need to know about Medicare coverage for radiation therapy, immunotherapy, and cancer drugs. 

Radiation Therapy

Radiation is a cancer treatment that targets cancer cells helping to slow the growth of tumors or prevent them from metastisizing. 

Medicare Part B does cover radiation services you receive in an outpatient setting. For example, Medicare Part A will cover the radiation services you receive at a hospital. 

Immunotherapy

Immunotherapy is a modern cancer treatment that uses your immune cells to fight off cancerous cells. 

In some cases, Medicare will cover immunotherapy. Immunotherapy is covered by Part A if you receive it at home or in a doctor’s office. While Part B covers immunotherapy, you receive it at a hospital. 

Cancer Medications

Part B Medicare does cover some cancer medications. For example, Part B will cover 80% of anti-nausea medications and IV cancer treatments. However, most other drugs aren’t covered under Medicare Part B.

The good news is that Medicare Part D prescription drug plans cover many of the medications Part B doesn’t, including injections you need at home and medicines that could prevent or reduce the spread of cancer. 

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Get Coverage For Your Cancer Treatments

So, does Medicare cover chemotherapy? Original Medicare and Medicare Advantage plans offer benefits for cancer treatments. But if you want to avoid paying out-of-pocket costs, Medigap may be for you. 

Are you looking for a Medigap plan that will have you completely covered in cancer? Contact a licensed insurance agent today and get the coverage you deserve!

If you qualify for Medicare but don’t know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.

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