Does Medicare Cover Chemotherapy Cost?

Does Original Medicare Cover Chemotherapy Costs?

Medicare covers many things. But, does Medicare cover chemotherapy? Yes, it can cover most chemotherapy costs. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

Medicare Part A

If admitted to a hospital stay to receive chemotherapy, Medicare A will do the job.  The Medicare Part A deductible is currently $1,316, which is taken for hospital admission. If the hospitalized patient stays in the hospital for more than 60 days, they will be responsible for a “per-day copayment.”

Medicare Part B

An oncologist may refer patients to an office or a clinic for chemotherapy. Medicare Part B has a yearly deductible of $183.  When the deductible is taken, Medicare Part B can cover up to 80% of chemotherapy costs. That leaves the patient paying the remaining 20% of chemotherapy costs. As a result, Medicare Part B may cover oral chemotherapy medicines as they become available.

Medicare Part D

Finally, Medicare Part D covers oral chemotherapy drugs. It is important to remember that there are out-of-pocket costs that come with Medicare Part D. Therefore, there is a chance that a patient will enter a Medicare Part D coverage gap and incur a high cost, due to the price of chemotherapy drugs. If limited income becomes an issue, patients may qualify for federal assistance to help pay the cost. In addition, pharmaceutical manufacturers also offer assistance programs for high-cost medicines, with which most oncologists are familiar.

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