Does Medicare Cover Chemotherapy?
The time after a cancer diagnosis is difficult for even the strongest of fighters. You shouldn’t have to worry about healthcare coverage, too — and Medicare takes care of that.
In 2021, the American Cancer Society reported 80% of all cancers in the U.S. are diagnosed in people 55 and older. If you’re in that age bracket and have Medicare , you’ll be covered for various cancer treatments, including chemotherapy.
Which Parts of Medicare Cover Chemotherapy?
If you’re in a hospital receiving chemotherapy, Medicare Part A provides in-patient coverage. For beneficiaries with Medicare Part B, you’ll be covered for chemotherapy as an outpatient, in a doctor’s office or in a freestanding clinic.
Part B coverage includes many of the standard chemotherapy drugs administered intravenously, as well as some oral chemotherapy.
If Part B doesn’t cover a particular cancer drug, Part D may cover it. Check with your Part D plan to see which chemotherapy drugs are covered. In addition to anti-nausea drugs and pain medication, Part D may cover chemotherapy prescriptions taken orally.
How Much Will Chemotherapy Cost With Medicare?
The amount of money you’ll pay for chemotherapy as a Medicare beneficiary depends on several things, including the type of drug you’re prescribed, as well as where you’re receiving treatment.
As a hospital outpatient receiving chemotherapy, you’ll be responsible for your Part B copay. In a doctor’s office or freestanding clinic, you’ll pay 20% of the Medicare-approved amount, as well as the Part B deductible.
It’s important to note that Medicare may not cover certain chemotherapy treatments given as part of a clinical trial .
Cancer costs U.S. patients $21 billion a year . To lower your out-of-pocket cancer drug costs, check your plan’s formulary (list of covered drugs) and the drug tier. Learn more about how to lower your Part D costs .
LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.