Does Medicare cover cancer?

Did you know that cancer is the second leading cause of death in the United States? It’s not always fatal, though. The sooner cancer is detected and treated, the better your chances of beating the disease and living a healthy, happy life. Aside from the disease itself, one of the most challenging aspects of cancer treatment is the cost. If you’re over age 65 and you’re looking for financial assistance with cancer treatments, we have some good news regarding Medicare.

Medicare may provide coverage for everything from cancer treatments to prescription drugs. This includes chemotherapy, radiation therapy, and anti-nausea drugs. If you or a loved one is battling cancer, it’s vital that you understand exactly what Medicare will and will not cover so that you can maximize your savings and get the best treatment possible.

What Part A and Part B cover

When you first become eligible for Medicare, you typically begin with what’s known as Medicare Part A. In terms of potential cancer treatment coverage, Part A usually covers hospitalization or inpatient services. If you receive treatments such as chemotherapy on an outpatient basis (away from a hospital setting), they will not be covered under Medicare Part A. Part A also covers radiation therapy only on an inpatient basis. You’ll typically pay an inpatient deductible for any treatments that you receive under Part A.

Medicare Part B also covers chemotherapy and radiation therapy, but unlike Part A, it does so on an outpatient basis. This means that hospital-based services are not covered, but chemo or radiation performed at a clinic or a doctor’s office is. Patients covered under Part B usually pay 20% of the coverage amount approved by Medicare for a particular procedure. The 20% is after the Part B deductible is taken into account. Part B plans may also cover cancer treatment drugs as well as anti-nausea drugs that are administered to help patients cope with chemotherapy sickness.

Cancer treatment drugs

Not all cancer treatment drugs are covered under Part B. Often patients opt for prescription drug plans found under Medicare Part C (also called Medicare Advantage) or Medicare Part D. These plans vary both in cost and in terms of the drugs covered. You should consult with your doctor and a Medicare specialist to ensure that you select the proper coverage for your needs. It’s also worth noting that Medicare Advantage/Part C plans sometimes restrict your choice of doctors and hospitals. They also often feature higher co-payments if your treatment schedule requires hospitalization or chemotherapy.

Another option that can help to fill the gaps in your Medicare cancer coverage is called, appropriately enough, Medigap. Medigap is a catch-all term for private insurance policies that pay your out of pocket costs. These usually require a monthly fee. Most Medigap plans also require you to already be enrolled in Medicare Part A or Part B. We can help you determine if Medigap is right for you.

In summary, Medicare does offer substantial coverage and savings to cancer patients. With the large number of plans and treatment options available, be sure you consult with your doctor to make sure you get the services you need.

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