MD Anderson accepts Medicare, but you need to verify your specific plan before scheduling

MD Anderson Cancer Center, located in Houston, Texas, is an in-network provider for Original Medicare (Part A and Part B). This means Medicare will cover a portion of your care there, and you will pay your share of the cost. However, acceptance of Medicare does not mean all your costs are covered — you will still owe deductibles, coinsurance, and copayments based on your plan.

If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your coverage at MD Anderson depends on your specific plan. Some Medicare Advantage plans include MD Anderson in their network; others do not. A few Medicare Advantage plans cover out-of-network cancer care at MD Anderson even if it is not in their standard network, but this varies widely. You must contact your plan directly to confirm whether MD Anderson is covered before you schedule an appointment.

Key Takeaways

  • MD Anderson is an in-network provider for Original Medicare (Part A and Part B), so Medicare will help pay for your care there.
  • If you have a Medicare Advantage plan, you must call your plan to confirm MD Anderson is in your network before scheduling, because coverage varies by plan.
  • Medicare covers only a portion of your care; you will still owe deductibles, coinsurance, and copayments.
  • MD Anderson's financial counselors can help you understand your out-of-pocket costs and discuss payment options if costs are a barrier.
  • If MD Anderson is out of network for your plan, you may still receive care there but will pay a larger share of the bill.

How to confirm MD Anderson is covered under your Medicare plan

The fastest way to confirm coverage is to call your Medicare plan directly. If you have Original Medicare, call Medicare at 1-800-MEDICARE (1-800-633-4227). They can tell you whether MD Anderson is in-network and what your costs will be for specific services.

If you have a Medicare Advantage plan, call the customer service number on the back of your insurance card. Have your member ID ready. Ask whether MD Anderson Cancer Center in Houston is in your plan's network. If it is not, ask whether your plan covers out-of-network cancer care and what your costs would be. Some plans have special rules for cancer treatment that differ from routine care.

You can also contact MD Anderson's financial counseling department directly at 713-792-2121. They work with patients every day and can often tell you quickly whether your specific plan is accepted. They may also be able to help you understand your out-of-pocket costs before your first appointment.

What your costs will look like at MD Anderson

If you have Original Medicare and MD Anderson is in-network, your costs depend on the type of service. For inpatient hospital care, you pay a deductible per hospital stay (the amount changes each year). For outpatient services like chemotherapy or radiation, you typically pay 20% coinsurance after you meet your Part B deductible.

If you have a Medicare Advantage plan, your costs depend on your specific plan's structure. Some plans have copayments for specialist visits or procedures; others use coinsurance. Your plan documents or customer service line can tell you the exact amount you will owe.

MD Anderson is a high-volume cancer center, and treatment there can be expensive. Even with Medicare, your out-of-pocket costs may be substantial, especially if you need surgery, chemotherapy, or radiation. This is why speaking with MD Anderson's financial counselors before treatment begins is important — they can discuss payment plans, financial hardship programs, and other resources that may reduce your costs.

If MD Anderson is out of network for your plan

If your Medicare Advantage plan does not include MD Anderson in its network, you have options. You can still receive care at MD Anderson, but you will likely pay a larger share of the bill. Out-of-network costs are typically higher than in-network costs, and your plan may not count out-of-network spending toward your out-of-pocket maximum in the same way.

Before choosing to go out of network, ask your plan whether they will cover the care at all and what your total responsibility would be. Some Medicare Advantage plans will not cover out-of-network care except in emergencies. Others will cover it but at a much higher cost to you.

If cost is a barrier, ask MD Anderson whether they have financial information programs or whether they can work with your plan to negotiate coverage. Some cancer centers have relationships with specific Medicare Advantage plans that allow them to provide in-network rates even when the plan's directory says otherwise.

Switching plans to access MD Anderson

If you have a Medicare Advantage plan that does not cover MD Anderson and you want to receive care there, you may be able to switch to Original Medicare or a different Medicare Advantage plan that does include MD Anderson. You can make changes during the Annual Enrollment Period (October 15 to December 7 each year) or if you have a may have access to life event, such as moving out of your plan's service area or losing other health coverage.

If you are newly diagnosed with cancer and your current plan does not cover MD Anderson, contact Medicare at 1-800-MEDICARE to ask about your options. They can tell you whether you may have access to for a special enrollment period that would let you switch plans outside the normal enrollment window. Some states have special rules for cancer patients that allow mid-year plan changes.

Switching plans takes time, so do this as soon as possible if you decide it is necessary. Your new coverage will not start until the first of the following month, so plan ahead.

What to bring to your first appointment at MD Anderson

Bring your Medicare card and any other insurance cards you have. Bring a photo ID and proof of address. Bring a list of all medications you are currently taking, including over-the-counter medications and supplements. Bring any medical records from previous doctors or hospitals, especially imaging scans, pathology reports, or previous treatment summaries.

Bring a list of questions you want to ask. Bring a notebook or have someone with you to take notes. Bring information about your financial situation if you think you may need help paying for care — MD Anderson's financial counselors can discuss options with you during your visit.

Frequently Asked Questions

Will Medicare cover all my cancer treatment at MD Anderson?

No. Medicare covers a portion of your care, but you will owe deductibles, coinsurance, and copayments. For inpatient care, you pay a deductible per hospital stay. For outpatient services, you typically pay 20% coinsurance after meeting your Part B deductible. Your total out-of-pocket costs depend on the type and length of treatment.

Can I use my Medicare Advantage plan at MD Anderson?

Only if MD Anderson is in your plan's network. Call your plan's customer service number to confirm. If MD Anderson is not in your network, you can still receive care there, but you will pay a larger share of the bill. Some plans have special coverage for cancer treatment, so ask specifically about that.

What if I cannot afford the out-of-pocket costs?

Contact MD Anderson's financial counseling department at 713-792-2121. They can discuss payment plans, financial hardship programs, and other resources. MD Anderson also works with nonprofit organizations that help cancer patients with costs. Do not delay treatment because of cost — financial counselors can often find options before your first appointment.

How long does it take to get an appointment at MD Anderson?

Wait times vary depending on the type of cancer and urgency of your case. For urgent cases, MD Anderson typically schedules appointments within one to two weeks. For routine consultations, it may take longer. Call MD Anderson directly at 713-792-2121 to ask about current wait times for your specific situation.

Do I need a referral from my doctor to see someone at MD Anderson?

No. You do not need a referral to schedule a consultation at MD Anderson. However, having your previous medical records sent to MD Anderson before your appointment helps them prepare. If you want your primary care doctor involved in your care, you can ask MD Anderson to send them updates about your treatment.