Does Medicare Cover Cancer Treatments?

Yes, Medicare Part A and Part B cover certain treatments for patients, including chemotherapy and radiation therapy. But your costs will depend on whether you receive chemotherapy as an inpatient or outpatient. When a patient gets treatment as a hospital inpatient, in this case Medicare Part A covers medical expenses while in case of freestanding clinic or doctor’s office, Medicare part B will cover the cost.

When a patient or may be a person who only wants to have general information about it, while internet surfing , he may first encountered with terms like this drug is covered under part A and that drug is covered under part B. So one have to understand that for what part A and part B actually stand for. So under Medicare part A, patient don’t have to pay by himself but in case of Part B, you’d pay 20 percent of the Medicare-approved amount, after paying the Medicare Part B deductible.

For all those services which are covered under Medicare Part B, patients must first pay the annual deductible that is set by Medicare each year. After paying that amount, Medicare pays 80% of all costs. In simple words , patients must pay 20% of the drug’s cost under Part B , no matter how high their total medical bills run. Part D is different. After you pay a certain deductible for your drugs, you must pay a percentage of your drug costs for the rest of the year, or until you reach the donut hole. This deductible amount is set each year.
Does Medicare Cover Cancer Treatments

Cancer Treatments Covered by Medicare

As is composed of different steps i.e. surgery, radiation, chemotherapy and People with Medicare who are being treated for cancer or who are cancer survivors have a number of special issues to think about. So following is step by step information about cancer treatment and Medicare:

Chemotherapy and Medicare

Medicare covers chemotherapy for cancer patients who are hospital inpatients and outpatients, as well as for patients in a doctor’s office or freestanding clinic. As mentioned earlier that Medicare costs depends on whether you receive chemotherapy as an inpatient or outpatient. Medicare Part A covers chemotherapy if the patient receive it as a hospital inpatient.

While Medicare Part B covers outpatient chemotherapy treatments i.e. treatment in a private doctor clinic or doctor’s office. In case of getting treatment privately at doctor clinic, you’d pay 20 percent of the amount which Medicare has approved, after paying the Medicare Part B deductible.

Radiation Therapy and Medicare

For radiation therapy, the principle is more or less same. Medicare also covers radiation therapy for cancer patients. As a patient covered under Medicare Part A, you’ll pay the inpatient deductible and any coinsurance that applies. But if you get radiation therapy in a freestanding clinic, 20% of the Medicare-approved amount you will have to pay, and the Medicare Part B deductible applies.

Medicare and Other Cancer Drugs

In case of other prescribed drugs, Medicare Part B cover only a limited prescription drugs, which may include some cancer drugs taken by mouth that may be administered to you. Medicare covered sometimes anti-nausea drugs to treat symptoms caused by chemotherapy treatment. But the basic principle is same, mostly you have to pay 20% of the Medicare-approved amount, after the annual Medicare Part B deductible is applied.

Exceptions

Some medications aren’t covered under original Medicare, these medications come under exceptions and you’ll need Medicare Part D coverage for them. Medicare part D is not always useful for such medications, you may have to pay the full cost of those drugs.

Patients can get this optional coverage through a stand-alone Medicare Part D prescription drug plan. It is also termed as a Medicare Advantage Prescription Drug plan. It is not necessary that every anti-cancer drug is covered by every Medicare plan. So firstly check the drug formulary of the plan you are considering buying in order to see if the medications you need are included or not. A formulary is a list of all the drugs covered by the plan.

Who’s Eligible For Medicare Coverage

Following is the list of people who are eligible for Medicare cancer treatment coverage:

  • People with Medicare Part A i.e. Hospital Insurance
  • People with Medicare Part B i.e. Medical Insurance

As mentioned above that Part A covers hospital inpatients while Part B covers hospital outpatients and patients in a doctor’s office or freestanding clinic. You pay 20% of the Medicare-approved amount if you get your treatment in a doctor’s office or freestanding clinic. The Part B deductible applies.

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