Does Medicare Cover Chemo and Radiation?
Medicare covers chemo and radiation as long as they are medically necessary. Medicare plans may cover other cancer treatments, along with a wide variety of screening and preventative services. Medicare covers chemo and radiation but may have deductibles and copays. A Medigap or Medicare Advantage plan can reduce out-of-pocket costs.
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UPDATED: Dec 7, 2021
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- Medicare plans cover chemo and radiation to treat cancer
- Medicare will also likely cover other cancer treatments and services, as long as they are medically necessary
- Medicare patients can take advantage of a wide variety of cancer screenings and preventative services
Does Medicare cover cancer treatment? If you are a cancer patient or know that you are at risk of being diagnosed with cancer, then understanding how your Medicare health insurance plan will cover services is important.
Does Medicare cover chemo and radiation? Does Medicare cover immunotherapy? Does Medicare cover other cancer treatments and services? We’ll answer these questions and more below.
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Does Medicare cover chemo and radiation?
Chemotherapy is a way to describe many different medications for cancer. The type of chemotherapy that a cancer patient needs depends on the type of cancer they are diagnosed with and how advanced it is. Chemotherapy can be administered orally, intravenously, or by injection.
Does Medicare cover chemotherapy? Most Medicare plans cover chemotherapy treatment. Medicare Part A covers inpatient treatment, while Medicare Part B covers outpatient treatment. Medicare Part D covers prescription drugs.
Radiation treatment uses high doses of radiation to target and kill cancer cells. Medicare Part A and Part B cover radiation treatment for cancer patients. Most Medicare Advantage plans also cover chemo and radiation treatment, but you should contact your provider to double-check.
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What other cancer treatments and services does Medicare cover?
Medicare insurance covers many other treatments for cancer, depending on the type of Medicare plan you have.
Medicare Part A covers inpatient treatments, such as cancer treatment you receive in a hospital, skilled nursing facility expenses, home health care or hospice care, and surgically-implanted breast prostheses after a mastectomy as part of inpatient surgery.
Medicare Part B covers outpatient treatments, such as doctors’ visits, chemotherapy, radiation, diagnostic tests, durable medical equipment (DME), outpatient surgeries, mental health services, nutritional counseling, preventative and screening services, and more.
Does Medicare cover immunotherapy for cancer? Immunotherapy is a category of medications that trigger your immune system to fight cancer cells. If immunotherapy is medically necessary, your Medicare plan may cover it.
Can I get screened for cancer with Medicare?
Medicare provides coverage for various cancer screenings.
Women who are 40 years and older with Medicare can get one screening mammogram every 12 months along with a baseline mammogram between the ages of 35 and 39.
Medicare Part B covers one Pap test and pelvic exam every 24 months, or every 12 months if you are at high-risk for cervical or vaginal cancer or are of childbearing age and have had an abnormal Pap test within the previous 36 months.
Medicare covers colorectal screening in the following ways:
- Screening fecal occult blood tests once every 12 months for people 50 and older
- Multi-target stool DNA lab test once every three years for people between 50 and 85 who have no symptoms of colorectal disease but are at average risk of colorectal cancer
- Screening colonoscopy once every 24 months for people who are at high-risk for colorectal cancer
- Screening flexible sigmoidoscopy once every 48 months for most people who are 50 and older
Medicare Part B covers lung cancer screening with low-dose computed tomography (LDCT) once a year for people who are over 55 years old, do not have symptoms, smoke or have quit smoking in the last 15 years, have a smoking history of at least 30 “pack years,” and get a doctor’s order.
If you are a man over 50 years old, and you and your doctor decide that you should be screened for prostate cancer, your Medicare plan will cover a digital rectal exam (DRE) and prostate-specific antigen (PSA) blood test once per year.
Medicare for cancer patients under 65 provides good coverage for cancer treatments and screening services. The best Medicare plans for cancer patients may be Medicare Advantage plans, as they are likely to have coverage for a wider variety of services. To learn more about Medicare plans, check out this link.
However, Original Medicare does offer coverage for some treatments. If you need to buy health insurance for cancer patients, enter your ZIP code into our free quote comparison tool below to get affordable health insurance quotes from companies in your area.