We all know by now that cancer is one of the most dangerous conditions around the world. Not only is it lethal, but it is also one of the most difficult and expensive conditions to treat.
And unfortunately, not everyone has the means to afford cancer treatment. Especially without health insurance to help pay for it.
So a common question many people have is, “Does Medicare Cover Cancer Treatment?” 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 on financial help for cancer patients.
Does Medicare Cover Cancer Treatment?
The short answer is yes; Medicare will cover the cost of cancer treatment. But not all treatments in all situations. 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.
Medicare will cover cancer treatments that your doctor prescribes. Certain therapies, such as holistic therapy for cancer, do not qualify for Medicare coverage.
Original Medicare (Medicare Part A and Part B) provides coverage for cancer treatment.
Medicare Part A covers cancer care and services. Part A’s coverage for cancer care includes the following:
- Treatment for your cancer
- Blood work
- Diagnostic testing that you receive while you are in a hospital
- Cancer surgery that is performed in an inpatient setting
- Surgically implanted breast prosthesis after a mastectomy
Medicare Part B provides coverage for most types of cancer treatment. Medicare Part B’s coverage for cancer care includes the following:
- Visits with your general practitioner
- Visits with your oncologist as well as other specialists for your cancer treatment
- Many diagnostic tests such as X-rays and blood work
- Cancer surgery that is performed in an outpatient setting
- Intravenous and some oral chemotherapy treatments
- Durable Medical Equipment, or in short DME, that you need while getting treatment for cancer
- Mental health services
- Certain preventive care screenings
Medicare Advantage plans (Medicare Part C) also provide coverage for cancer treatment. They cover everything Original Medicare covers as well as offer some additional benefits. However, exactly what it covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.
Medicare Part D also provides coverage for certain medications that your healthcare provider will prescribe for your cancer treatment. Some of those medications will include oral chemotherapy drugs, anti-nausea meds, pain meds, and many more.
For some of the doctor’s visits and procedures, you need to meet certain criteria to be approved by Medicare. Say, for example, you want a third opinion from an oncologist. Medicare will pay for it, but only if your first two oncologists do not agree with each other.
Medicare pays for 80 percent of all cancer treatment and cares that you will receive. You will pay for the remaining 20 percent.
How Much Does Cancer Treatment And Care Cost?
There are many different types of cancer treatments. Chemotherapy, surgery, immunotherapy, genetic therapy and more. Costs vary widely depending on type the treatment, the type of cancer you have and your location.
Chemotherapy, the main treatment doctors use to fight cancer, cany cost anywhere from $10,000 to $200,000.
But that’s just one component of one type of treatment. It doesn’t take into account other drugs you may need, the cost of countless doctor’s appointments, therapy, and on and on.
Medicare will help pay for many of these costs. However, if you need financial help to cover the costs of cancer treatments, there are other options. For a list of resources, visit the CancerCare website here.
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 medical expenses abroad?