Medicare Cancer Coverage Explained: What You Need to Know for Treatment

Suppose you or a loved one is diagnosed with cancer. After the initial shock and discussions with your doctors take place, it’s crucial to understand how to pay for treatment.

So, does Medicare cover cancer treatment? Fortunately, the answer is yes. Most aspects of cancer treatment and care, ranging from medications to doctor appointments and hospital stays, are typically covered by a combination of Medicare parts.

Here’s a look at what you need to know about Medicare coverage for cancer treatment so you can plan for the potential financial impact of medical care.

Does Medicare Cover Cancer Treatment?

Medicare covers many aspects of cancer care, but different treatments and services fall under different parts of Medicare, and you may encounter some limitations. Here’s a closer look at which parts of Medicare pay for different aspects of cancer treatment.

• Medicare Part A: For inpatient hospital stays and other overnight care, you’ll look to Medicare Part A. This coverage includes inpatient hospital services, such as cancer treatments, skilled nursing facility care after a qualifying hospital stay, home health care and hospice care.
• Medicare Part B: Helps cover many medically necessary outpatient cancer-related services, including doctor visits, chemotherapy, radiation and diagnostic tests. It also helps cover durable medical equipment, certain dental services, outpatient surgeries, mental health care and some preventive and screening services.
• Medicare Part D: Provides prescription drug coverage, including many oral chemotherapy drugs, anti-nausea medications, pain relief and other prescriptions used in cancer treatment. Common medications for cancer treatment that may be covered include:
• Anastrozole (Arimidex)
• Busulfan (Myleran)
• Capecitabine (Xeloda)
• Erlotinib (Tarceva)
• Temozolomide (Temodar)

To get Medicare Part D coverage, you must join a Medicare drug plan or a Medicare Advantage plan with drug coverage (also called a MAPD plan). It’s important to check that your medications are on your plan’s formulary, as this affects your costs.

Medicare Advantage (Part C)

Medicare Advantage (Part C) plans are Medicare-approved private insurance options that bundle Part A, Part B and usually Part D coverage, offering at least the same benefits as Original Medicare but with different rules, costs and provider networks. It’s important to confirm that your providers accept your plan and review plan materials to understand your specific benefits.¹

Getting familiar with your plan’s coverage, reviewing plan documents and working with your healthcare provider’s billing department can help you better understand exactly what’s included in your plan.

Medicare Supplement

Medicare Supplement Insurance works alongside Original Medicare (Parts A and B) to help pay for copays, coinsurance and other out-of-pocket costs. It can help reduce your share of costs for cancer-related services like inpatient hospital stays, doctor visits and outpatient chemotherapy.

What’s Typically Covered Under Medicare for Cancer Treatment?

Does Medicare pay for chemotherapy? Does Medicare cover radiation therapy? Yes, Medicare covers most common cancer treatments.

Your doctor’s office likely has extensive experience dealing with Medicare, and it doesn’t hurt to ask if you have questions about costs and coverage.

What Medicare Doesn’t Cover in Cancer Treatment

Medicare typically only pays for treatments that are tested and well-established. Treatments that generally fall outside of Medicare coverage can include:²

• Experimental or unapproved treatments: Medicare doesn’t cover therapies that aren’t FDA-approved or widely accepted as standard care. Patients may seek clinical trials, or look to alternate sources to cover these newer treatments like personal savings, nonprofit programs or crowdfunding.
• Long-term custodial care: Extended stays in nursing homes or help with daily activities aren’t covered since Medicare pays only for short-term skilled care. Long-term care alternatives include Medicaid, long-term care insurance or private pay.
• Cosmetic procedures: Surgeries or treatments solely for appearance aren’t covered, as they’re not considered a medical necessity. Patients typically pay out-of-pocket or use medical financing to pay for these costs. Examples may include reconstructive surgery or scar removals following certain cancer treatments.
• Alternative therapies: Services like acupuncture (except for limited chronic pain cases), herbal treatments or naturopathy aren’t covered. Patients often use self-pay or funds from an HSA or FSA.

Costs That Are Not Covered for Cancer Treatment Under Medicare

Even with the most extensive coverage, you may still have some out-of-pocket costs related to medical care for cancer.

Copayments, coinsurance and deductibles

Even when Medicare covers a service, you’re still responsible for certain out-of-pocket costs like copayments, coinsurance and deductibles. These costs can add up quickly, especially for ongoing treatments like chemotherapy or radiation.

Supplemental insurance can reduce costs

Medicare supplement insurance helps pay for some of the costs that Original Medicare doesn’t cover, such as coinsurance and deductibles. Typically, the best time to consider a Medicare supplement plan is during your six-month Medicare supplement Open Enrollment period with is a one-time period that begins the first month you have Medicare Part B and you’re 65 or older. During this period, you can enroll for the first time or switch plans and insurers can’t deny you coverage for any health issues you may have. After your Open Enrollment Period, you may be subject to underwriting and may not qualify for a policy.

Programs that help with financial assistance

If you’re struggling to afford your care, programs offered by nonprofit organizations, hospitals and state agencies may help cover treatment or medication costs. Cancer insurance can also provide a lump-sum cash benefit to help with expenses.

How to Get the Most Out of Your Medicare Cancer Coverage

Outside of reviewing your coverage regularly and making needed updates, like during the annual open enrollment period, you can follow these steps to ensure you’re making the most of your Medicare coverage.

• Work with a trusted agent/producer: You can work with a trusted insurance agent/producer to navigate your options and find the best plan for your potential cancer coverage needs. You can also choose a Medicare supplement plan to help you manage out-of-pocket spending.
• Get support handling Medicare forms: If you’ve been diagnosed with cancer, your doctor’s office can be a helpful resource. Case managers, patient advocates or an ombudsmen can help you deal with challenges handling paperwork, online forms, denials and answer questions about your plan.
• Read your statement details: For those looking to get into the details of your Medicare coverage, you can learn more using Medicare billing codes. Treatment must come from a licensed provider and fall within a billing code that indicates a treatment was medically necessary.³

Medicare and Cancer Care: Final Thoughts

Medicare covers many critical parts of cancer care, from doctor visits and treatments to preventive screenings, but there are still gaps where you may have to pay. Out-of-pocket costs, coinsurance and coverage limits may create financial uncertainty during an already difficult time.

To improve your odds of beating a cancer diagnosis, early detection is key. Knowing how Medicare pays for cancer screenings like mammograms and PSA tests can help you access these potentially lifesaving tests, sometimes with no out-of-pocket cost.

Frequently Asked Questions

Q1: Does Medicare cover chemotherapy?

Medicare Part B covers most chemotherapy drugs given in a doctor’s office or outpatient clinic, while Part D may cover oral chemotherapy medications.

Q2: Does Medicare cover radiation therapy?

Yes. Medicare Part B covers outpatient radiation therapy when it’s deemed medically necessary by a treating physician.

Q3: Does Medicare cover cancer screenings and early detection tests?

Medicare Part B covers many preventive screenings, like mammograms, colonoscopies and Pap tests, frequently at little or no cost.

Q4: Are cancer drugs covered under Medicare Part D?

Medicare Part D covers many prescription cancer drugs, including certain oral chemotherapy, anti-nausea medications and pain relievers used in treatment. Be sure to check your plan’s formulary to see what medications it covers.

Q5: Can I use Medicare to reduce my cancer treatment costs?

Yes, Medicare helps pay for many cancer treatments and services, and adding a Medicare supplement insurance or choosing a Medicare Advantage plan may further reduce out-of-pocket expenses.

Sources

¹Medicare.gov. PDF: Medicare Coverage of Cancer Treatment Services. Retrieved Jul. 30, 2025 from https://www.medicare.gov/publications/11931-medicare-coverage-of-cancer-treatment-services.pdf

²Medicare.gov. Web page: What’s not covered? Retrieved Aug. 7, 2025 from https://www.medicare.gov/providers-services/original-medicare/not-covered

³CMS.gov. Web page: Billing and Coding: Medical Necessity of Therapy Services. Retrieved Aug. 7, 2025, from https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53304&ver=15&

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