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.