A cancer diagnosis can be scary, but if you have Medicare, most cancer treatment is generally covered. If you have additional protection with a Medicare Supplement Plan, your out-of-pocket costs could be very low, depending on the Medicare Supplement plan you choose. Read on to learn how Medicare pays for cancer treatment.
How does Medicare cover cancer treatment?
How Medicare pays for cancer treatment depends on the type of treatment you need and where you get your cancer treatment.
According to the National Cancer Institute, your doctor may treat your cancer in one or more of the following ways:
- Surgery. During surgery, your doctor may use a scalpel, laser, or liquid nitrogen to remove or debulk a cancerous tumor, and to help relieve symptoms associated with your cancer. If the surgery is done on an outpatient basis, Part B generally pays 80% of allowable charges after you meet your deductible. If your cancer treatment is done while you are an inpatient in the hospital, Part A generally covers your care after you meet your deductible.
- Radiation therapy. Radiation therapy can be internal or external, depending on the type of cancer you have. Most radiation treatment is done in an outpatient facility, so Part B would typically cover radiation cancer treatment.
- Chemotherapy. Chemotherapy uses drugs to cure cancer or slow its growth. Depending on the type of chemotherapy your doctor prescribes, you may get treated at home, at an outpatient infusion center, or at the hospital as an inpatient. Chemotherapy is often used in combination with other types of cancer treatments such as surgery and radiation. If you get treatment as an outpatient, Part B generally covers your care. If you are an inpatient, Part A may pay.
- Immunotherapy, targeted therapy, and precision medicine. These are less common types of cancer treatment, and many types of targeted therapies and precision medications are being studied through clinical research trials. Medicare may cover costs associated with participating in clinical trials.
You generally must meet your Part A and Part B deductibles before Medicare pays its share for cancer treatment, and in most cases, there is a 20% coinsurance amount for covered charges under Part B.
Do Medicare Supplement Plans pay for cancer treatment?
Medicare Supplement Plans may pay some or all of your out-of-pocket costs for cancer treatment under Part A and Part B. Depending on the Medicare Supplement plan you choose, your plan may pay
- your coinsurance amounts under Part A and Part B
- your Part A and/or Part B deductibles
- your Part B excess charges
- as well as coinsurance under Part A for hospice care and skilled nursing care.
Do Medicare Supplement Plans pay for cancer treatment drugs?
Medicare Supplement Plans generally only pay your share of covered costs under Part A and Part B. Generally if Medicare Part A or Part B covers your cancer treatment drug, so will your Medicare Supplement Plan. Most chemotherapy drugs and medications you receive in a doctor’s office or infusion clinic are generally covered by Medicare Part B. Medicare Part A generally covers prescription medications you take while you are an inpatient in the hospital.
Medicare Supplement Plans typically do not, however, pay for other prescription medications you take at home to treat your cancer symptoms or treatment side effects. Your Medicare Part D Prescription Drug Plan should cover most of these medications. Keep in mind that Medicare Supplement Plans generally do not cover any out-of-pocket costs associated with Part D coverage for prescription drugs.
Have more questions about Medicare? Read this next to find answers: Top 5 Medicare and Medicare Supplement FAQ’s Answered
By David Lasman – “Ask Medicare Dave” | President – Senior Healthcare Team
wwww.SeniorHealthcareTeam.com | 866-333-7340
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