Radiation therapy uses high-intensity beams of energy to destroy cancer cells by destroying their DNA. Thus, cancer cells will not have the chance to multiply and spread throughout the body.
It is often performed along with other cancer treatments such as chemotherapy or surgery. Though it can be an effective treatment against cancer, not everyone who needs it can easily afford it.
So a common question many people have is, “Does Medicare cover Radiation?” In this article, we answer the question in clear, plain English. You will also find the average costs of radiation therapy and other helpful info.
Does Medicare Cover Radiation?
The short answer is yes; Medicare will cover the cost of radiation therapy. 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 radiation therapy. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for radiation therapy costs. Medicare Part A provides coverage for any radiation therapy that you receive in an inpatient setting. Along with that, Medicare Part A also covers any medication that you receive during your inpatient stay, as well as the meals given to you.
Medicare Part B covers provide coverage for radiation therapy that you receive in an outpatient setting. It will cover 80 percent of the costs of radiation therapy.
Medicare Advantage plans (Medicare Part C) also provide coverage for radiation therapy. They cover everything Original Medicare covers as well as offer some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.
Many Medicare Part C plans cover 80 percent of the costs until you reach the out-of-pocket maximum. After hitting the out-of-pocket maximum, they provide 100 percent coverage.
How Much Does Radiation Therapy Cost?
On average, radiation therapy can cost from $10,000 to $50,000. However, the price can go higher than $50,000. The exact costs of your radiation therapy depend on many factors, including the type of cancer, the number of treatments, and the type of radiation therapy. Most of the time, external beam radiation therapy costs less than internal beam radiation therapy.
Two Types Of Radiation Therapy
The two types of radiation therapy are external beam radiation therapy and internal beam radiation therapy.
External beam radiation therapy uses a machine that directs the energy beams to a specific site in your body. It can target the specific site of the tumor without affecting other parts of the body, even those close to the tumor.
Internal beam radiation therapy is an internal treatment that is either in a liquid or solid form. It is often given through an IV if it is administered in liquid form. On the other hand, if it is administered in solid form, it is through pills or small particles placed at or near the site of the tumor.
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 Invisalign?