Medicare covers most cancer treatments, but the type of coverage and your out-of-pocket costs depend on which part of Medicare you have and which treatment your doctor prescribes.

Medicare Part A covers inpatient hospital stays for cancer treatment, including surgery and chemotherapy given during hospitalization. Medicare Part B covers outpatient services: chemotherapy infusions at a clinic, radiation therapy, imaging scans, lab work, and visits with your oncologist. If you have a Medigap or Medicare Advantage plan, your coverage may be broader and your costs lower, but the base Medicare program does cover the major cancer treatments.

The catch is that you will pay a share of the cost. Part B charges a 20% coinsurance after you meet your annual deductible (which varies by year). Part A requires a copay for hospital days. Prescription cancer drugs taken at home fall under Part D, which has its own deductible and coverage gaps. Understanding which part covers what, and what you owe, matters before treatment starts.

Key Takeaways

  • Medicare Part A covers inpatient cancer surgery and chemotherapy; Part B covers outpatient chemotherapy, radiation, imaging, and oncology visits.
  • You pay 20% coinsurance on Part B services after meeting your annual deductible, and a daily copay for hospital stays under Part A.
  • Oral cancer medications are covered under Part D (prescription drug coverage), which has separate deductibles and may include coverage gaps called the "donut hole."
  • Medicare Advantage and Medigap plans may offer lower out-of-pocket costs and broader coverage than Original Medicare alone.
  • Asking your oncology office to verify coverage before your first appointment can prevent surprise bills and help you plan for costs.

What Medicare Part A Covers for Cancer

Part A covers hospital inpatient stays when you need surgery to remove a tumor, or when you are admitted for chemotherapy or other treatment that requires overnight care. It also covers some skilled nursing facility care after hospitalization if your doctor orders it as part of your recovery.

You pay a deductible for each hospital stay (the amount changes yearly), then a daily copay for days 1 through 60, a higher daily copay for days 61 through 90, and an even higher amount for days beyond 90. If your cancer treatment requires multiple hospital admissions, you may pay multiple deductibles. Ask the hospital billing office to estimate your costs before admission so you know what to expect.

What Medicare Part B Covers for Cancer

Part B is where most of your cancer care happens. It covers outpatient chemotherapy infusions at a hospital or clinic, radiation therapy, CT scans and PET scans, blood tests and tumor markers, pathology reports, and all your visits with your oncologist and other specialists. It also covers some supportive care: anti-nausea medications given by IV, blood transfusions, and bone marrow or stem cell transplants.

You pay 20% of the Medicare-approved amount for each service after you meet your annual Part B deductible. This means if your oncologist orders a scan that Medicare approves at $1,000, you pay $200 (20%) once you have met your deductible. If your doctor uses an out-of-network provider, you may owe more. Always ask your oncology office whether your doctor and the facility are in-network with Medicare.

Prescription Cancer Drugs and Part D Coverage

If your cancer treatment includes pills or injections you take at home — such as targeted therapy drugs or immunotherapy — those are covered under Medicare Part D, your prescription drug plan. Part D has its own annual deductible, a copay or coinsurance for each drug, and a coverage gap (sometimes called the "donut hole") where you pay a larger share of the cost once you reach a certain spending threshold.

Some cancer drugs are expensive and can push you into the coverage gap quickly. Once you spend enough out of pocket, catastrophic coverage kicks in and Medicare pays most of the cost. Ask your Part D plan which cancer drugs are on its formulary (the list of covered drugs) and what tier they are on — higher tiers mean higher copays. Many drug manufacturers offer copay information programs if your out-of-pocket costs are high; your oncology office can help you find these.

How Medicare Advantage Plans Handle Cancer Treatment

If you have a Medicare Advantage plan (Part C), it must cover everything Original Medicare covers, but it often has lower copays and coinsurance, especially for cancer care. Many Advantage plans have $0 copays for chemotherapy or radiation. However, Advantage plans use networks, so you must use in-network oncologists and hospitals or pay more out of pocket.

Before starting cancer treatment, call your Advantage plan and ask what your copay will be for chemotherapy, radiation, imaging, and any oral medications. Ask whether your chosen oncologist and cancer center are in-network. If your current plan does not cover your preferred provider, you may be able to switch plans during the open enrollment period, though this depends on your plan's rules and your state.

Medigap Coverage and Cancer Care Costs

A Medigap policy (supplemental insurance) pays some or all of the copays and coinsurance that Original Medicare leaves you responsible for. If you have Medigap Plan G or Plan F, for example, it covers your Part B coinsurance, which means you pay nothing for that 20% after your deductible. This can save thousands of dollars during cancer treatment.

Medigap does not cover everything — it does not cover Part D prescription drugs, and it does not cover services Medicare does not cover. But for the services Medicare does cover, a good Medigap plan can reduce your out-of-pocket costs significantly. If you do not have Medigap and are worried about costs, ask your oncology office about financial information programs or hospital charity care.

Clinical Trials and Experimental Treatments

Medicare covers routine care costs for patients in approved clinical trials, including chemotherapy, imaging, and lab work related to the trial. However, it does not cover the experimental drug or device itself — the trial sponsor usually pays for that. If your oncologist mentions a clinical trial, ask whether Medicare will cover your routine care costs and what the trial sponsor covers.

Clinical trials can be a way to access newer cancer treatments before they are widely available, and Medicare's coverage of routine care makes them more affordable. The National Cancer Institute maintains a searchable database of trials at cancer.gov; you can search by cancer type and location to find trials near you.

What to Do Before Your First Oncology Appointment

Call your oncology office and ask them to verify your Medicare coverage before your first appointment. Give them your Medicare card number and tell them which parts you have (Original Medicare, Advantage, Medigap, Part D). Ask them to tell you: your deductible status, your copay or coinsurance for chemotherapy and imaging, whether they are in-network, and whether any drugs your doctor is likely to prescribe have coverage limits or require prior authorization.

Prior authorization means Medicare or your plan requires your doctor to get approval before paying for a specific drug or procedure. This can delay treatment by a week or two, so knowing about it early matters. If your oncology office cannot answer these questions, ask for the billing department or call Medicare directly at 1-800-MEDICARE to verify your coverage yourself.

Frequently Asked Questions

Does Medicare cover wigs or prosthetics after cancer treatment?

Medicare does not cover wigs or hairpieces. It does cover breast prosthetics (artificial breasts) and bras with built-in prosthetics after mastectomy, but only if your doctor prescribes them as a prosthetic device. Ask your surgeon whether they will write a prescription; if so, you pay 20% coinsurance after your Part B deductible.

What if my cancer treatment costs more than Medicare pays?

If you have Medigap, it covers most of the gap. If you have Original Medicare only, you are responsible for the coinsurance and copays. Many cancer centers have financial information programs or social workers who can help you find grants or payment plans. The American Cancer Society and CancerCare also offer financial support to patients with limited income.

Does Medicare cover travel costs to a cancer center far from home?

Medicare does not cover travel, lodging, or meals. Some cancer centers offer housing programs for patients traveling for treatment. The National Association of Hospital Hospitality Houses maintains a directory of free or low-cost housing near major cancer centers. Ask your oncology office's social worker whether they know of programs in your area.

Can I switch Medicare plans if I am diagnosed with cancer?

You cannot switch Original Medicare to a Medicare Advantage plan outside the annual open enrollment period (October 15 to December 7) unless you have a may have access to life event. A cancer diagnosis alone does not may have access to. However, if you are newly may be able to access for Medicare because of your diagnosis, you can enroll during your initial enrollment period. Ask Medicare or your plan about your specific situation.

Does Medicare cover genetic testing for cancer risk?

Medicare covers genetic testing (such as BRCA testing) if your doctor orders it as medically necessary — usually because you have a personal or family history of certain cancers. You pay 20% coinsurance after your Part B deductible. Ask your doctor whether the test meets Medicare's criteria before scheduling it.