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Medicare covers a range of cancer treatments, including chemotherapy, radiation, surgeries and related services and supplies.
Different kinds of treatments are covered by different parts of Medicare, so the specifics of what’s covered and your out-of-pocket costs can vary.
Here’s what you need to know about how Medicare covers some of the major kinds of cancer treatments.
Does Medicare cover chemotherapy?
Yes, Medicare covers chemotherapy — both oral chemotherapy drugs and chemotherapy that’s administered through a vein.
Chemotherapy at a doctor’s office or clinic
Medicare Part B covers medically necessary chemotherapy when it is administered at a doctor’s office or outpatient clinic. For Part B services, Medicare generally pays 80% of the approved cost after you meet your Part B deductible —$226 in 2023.
You’re responsible for the other 20% as coinsurance. If you have Medicare Supplement Insurance, or Medigap, it could cover the coinsurance.
Medicare Advantage plans must cover the same benefits covered by Medicare Part A and Part B, so outpatient chemotherapy is covered by Medicare Advantage, too. Deductibles, coinsurance and copays vary, so check with your plan to see what your out-of-pocket costs would be.
Medicare Part D covers certain prescription chemotherapy drugs that you take by mouth rather than having them administered at a medical facility.
If you have Original Medicare, you can buy a stand-alone Medicare Part D plan to get prescription drug coverage. Most Medicare Advantage plans include prescription drug coverage, in which case you can’t buy a separate Part D plan.
Whether you have a stand-alone Part D plan or Medicare Advantage prescription drug coverage, you’ll need to check your plan’s formulary to see what drugs are covered and what your costs would be.
Does Medicare cover radiation therapy?
Yes, Medicare covers medically necessary radiation therapy to treat cancer. If you get radiation therapy as a hospital inpatient, it’s covered by Medicare Part A. After you meet the Medicare Part A deductible of $1,600 in 2023, there are no copays for your hospital stay for the first 60 days.
If you get radiation therapy in a freestanding clinic or at an outpatient hospital department, it’s covered by Medicare Part B. You would owe 20% of Medicare’s approved cost unless you have a Medigap policy to cover that coinsurance.
If you have Medicare Advantage, you’re covered for medically necessary radiation therapy as well. Check with your plan for details on provider and hospital networks and what your costs would be.
Does Medicare cover cancer surgery?
Yes, Medicare covers medically necessary cancer surgeries.
If you have surgery when you’re in the hospital as an inpatient, it’s covered by Medicare Part A. The hospital stay related to the surgery would be covered as well. There are no copays for the first 60 days in the hospital once you’ve met your Medicare Part A deductible: $1,600 in 2023.
If you have surgery as an outpatient at the hospital or somewhere else, such as a clinic or ambulatory surgical center, it’s covered by Medicare Part B, instead. You would owe 20% of Medicare’s approved amount for the procedure, but a Medigap policy could cover that for you.
Medicare Advantage plans must cover at least the same benefits as Medicare Part A and Part B, so Medicare Advantage would cover medically necessary inpatient or outpatient cancer surgery. Costs and provider networks vary by plan.
Does Medicare cover other cancer treatment services?
Medicare covers many other cancer-related services, including screenings, tests, treatments, therapies and stays at certain medical facilities.
For example, Medicare covers:
There are often criteria and limitations for coverage, so you’ll need to look into the details for specific services. For an overview of what cancer-related services Medicare covers and how, read the Medicare Coverage of Cancer Treatment Services booklet from the Centers for Medicare & Medicaid Services.
What Medicare covers
Medicare covers a lot of things — but not everything. Find out where Medicare stands in the following areas: