Does Medicare Cover Cancer Treatment?

Does Medicare Cover Cancer Treatment – Overview

Cancer treatment is costly. However, Medicare offers relief by covering some treatments under its Part A and Part B Plans.

These plans can cover the expense of consultation visits for surgical cancer treatment. You may also need to pay some expenses from your pockets, depending on your Medicare plan type.

In this article, we’ve shown which Medicare insurance plans to cover the cost of cancer treatment. We have also detailed some everyday out-of-pocket expenses during cancer treatment.

Does Medicare Cover Cancer Treatment

Medicare insurance plans are named Part A, B, C, and D. Each covers different aspects of cancer treatment. Let’s take a look at it.

Medicare Part A and Cancer Treatment

Medicare Part A offers coverage for eligible cancer treatments, especially if the treatment involves an inpatient hospital stay.

For instance, Medicare Part A covers expenses of:

  • The inpatient stays in the hospital for surgical treatment of cancer
  • Inpatient chemotherapy
  • A skilled nursing facility stay after a hospital stay of at least 3 days
  • Physical and occupational therapy costs
  • Hospice care expenses
  • The surgical implant of breast prostheses after a mastectomy procedure
  • Blood transfusion
  • Clinical research expenses at hospitals

Medicare Part B and Cancer Treatment

If you have a Medicare Part B insurance plan, then you can expect the insurer to cover the cost of the following for cancer treatment:

  • Outpatient radiation therapy
  • Outpatient chemotherapy
  • Oral chemotherapy
  • Surgery may not be specifically for administering chemotherapy but could involve cancer-related surgical procedures as an outpatient service
  • External breast prostheses following a mastectomy
  • Durable medical equipment such as a walker or supplemental oxygen
  • Feeding tubes and pumps
  • Cost of medical research as an outpatient
  • Diagnostic tests such as CT scans
  • Doctor’s office visits
  • Certain diagnostic screening tests

Medicare Part C and Cancer Treatment

Medicare Part C, also known as Medicare Advantage, offers some coverage for cancer-related diagnostic and treatment procedures.

This plan offers to cover the expenses covered under Original Medicare insurance plans. These include benefits provided under Medicare Part A and Part B combined.

However, the rules and rates for this health insurance policy vary significantly from the cost of Original Medicare plans.

Medicare Part D and Cancer Treatment

Medicare Part D is a separate plan that covers prescription drugs and is not included as a benefit of Medicare Advantage but can be added to it to cover expenses of prescription medications for cancer treatment.

For instance, if Medicare Part B cannot cover a specific drug and the person has Medicare Part D, then this covers the cost.

Medicare Part D also covers the cost of medications that help counteract cancer treatment’s effects, such as anti-nausea drugs.

Medicare and Chemotherapy for Cancer Treatment

Chemotherapy involves administering drugs intravenously or through an implanted port to treat cancer. This treatment is provided as an outpatient or an inpatient procedure, based on the patient’s type of cancer.

Medicare insurance covers the cost of chemotherapy as cancer treatment, provided the doctor considers the treatment medically necessary.

Usually, chemotherapy is administered in hospitals, but it can also be administered at home.

Medicare Part D may cover the cost of chemotherapy if administered orally and other cancer treatment drugs.

Non-Medicare covered expenses for Cancer Treatment.

Under Medicare Part B, the insurer covers 80% of the approved amount for many covered services after meeting the annual deductible (the deductible amount should be updated if incorrect for the current year).

You must pay the remaining 20% of the cost out of your pocket.

Under Medicare Part A, the expenses for inpatient cancer treatment are covered. You may need to pay a $1,632 deductible for every benefit period. (1)

The specific out-of-pocket expenses vary according to the number of days the patient spends in the hospital.

The overall cancer treatment cost depends on the doctor, facility, patient’s income, and treatment location.

On average, the yearly out-of-pocket costs for Medicare beneficiaries are $4,835 for in-network services and $8,659 for both in-network and out-of-network services (PPOs). (2)

To help cover these out-of-pocket expenses, you can supplement Medicare with Medigap plans.

Conclusion

Different parts of Medicare cover different aspects of cancer treatment. Some Medicare plans cover the expenses of medication and implants, while others cover the cost of treatment and hospital stays.

The out-of-pocket expenses vary between these different insurance plans.

It is highly advisable to consult with your doctor regarding recommended screenings, treatments, and medications.

This way, you can ensure that your chosen Medicare plan covers the maximum amount of the total cancer treatment costs.

See Also

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Cancer Clinical Trials

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Grants for Cancer Research

Breast Cancer Grants

Does Medicare Cover Colonoscopy

Does Medicare Cover Chiropractic

Does Medicare Cover Hearing Aids

Does Medicare Cover Cataract Surgery

DHHS Grant Program

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