We’re living longer than ever. So while it is more common to develop cancer in your 70s or 80s, it is also more common to find effective treatment. However, cancer treatment is quite expensive.
So a common question many people have is, “Does Medicare Cover Cancer Treatment After Age 76?” In this article, we answer that question in clear, plain English. You will also find the average costs of cancer treatment and other helpful info.
Does Medicare Cover Cancer Treatment After Age 76?
The short answer is yes; Medicare will cover the cost of cancer treatment. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your cancer treatment. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for cancer treatment after age 76. No matter how old you are, Medicare will provide coverage for the costs of your cancer treatment. Medicare provides coverage for many types of treatments for cancer such as:
- Hormone therapy
- Genetic therapy
Even though Medicare usually provides coverage for cancer treatment, it does not cover alternative or holistic therapy.
Medicare Part A provides coverage for cancer care and services in an inpatient setting. Here are some of the services that Medicare Part A covers for cancer care:
- Blood work
- Diagnostic testing that you receive while you are in a hospital
- Cancer surgery that takes place in an inpatient setting
- Surgically implanted breast prosthesis after a mastectomy
On the other hand, Medicare Part B provides coverage for cancer treatment in an outpatient setting. Here are some of the services that Medicare Part B covers for cancer care:
- A visit with your general practitioner
- A visit with your oncologist and/or other specialists for your cancer treatment
- Many diagnostic tests including X-rays and blood work
- Cancer surgery that takes place in an outpatient setting
- Intravenous and some oral chemotherapy treatments
- Durable Medical Equipment that you need while you are having treatment for your cancer
- Mental health services
- Certain preventive care screenings
Medicare pays for 80 percent of all cancer treatment and care that you will receive. You will pay for the remaining 20 percent.
Part C Coverage for Cancer Treatment After Age 76
Medicare Advantage plans (Medicare Part C) also provide coverage for cancer treatment. Part C plans cover everything Original Medicare covers as well as offers some additional benefits. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.
Part D Coverage for Cancer Treatment After Age 76
Medicare Part D provides coverage for prescription medications that your healthcare provider will prescribe for your cancer treatment. These medications include oral chemotherapy drugs, anti-nausea medications, pain medications, and many more.
Though Medicare usually provides coverage for cancer treatment, some doctor’s visits and procedures have criteria that you must meet before Medicare provides coverage.
How Much Does Cancer Treatment And Care Cost?
Chemotherapy usually costs somewhere from $10,000 to $200,000.
The exact costs of your cancer treatment will vary on many factors. Some of these factors include the type of cancer, how far along the cancer is, the treatment you get and many more.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover chemo infusions?