Yes, Memorial Sloan Kettering Cancer Center accepts Medicare, but coverage depends on which part of the hospital system you use and how your specific plan is structured.

Memorial Sloan Kettering (MSK) is an in-network provider for Original Medicare (Parts A and B) in New York, New Jersey, and Connecticut. This means Medicare will cover inpatient hospital care, outpatient surgery, and physician services at MSK facilities when medically necessary. However, the amount you pay out of pocket — your deductible, copayment, or coinsurance — follows Original Medicare rules, not MSK's own pricing.

If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your coverage at MSK depends entirely on your specific plan's network. Some Medicare Advantage plans include MSK in their network; others do not. You need to check your plan documents or call your plan's customer service line to confirm whether MSK is covered before scheduling treatment.

Key Takeaways

  • Memorial Sloan Kettering is an in-network provider for Original Medicare (Parts A and B) in New York, New Jersey, and Connecticut.
  • If you have a Medicare Advantage plan, you must verify that MSK is in your plan's network before scheduling, because coverage varies by plan.
  • Original Medicare covers inpatient hospital stays, outpatient procedures, and physician services at MSK, but you pay your deductible and coinsurance as usual.
  • MSK's financial counselors can help you understand your out-of-pocket costs and discuss payment options if bills are high.

How Original Medicare Coverage Works at MSK

When you use Original Medicare at Memorial Sloan Kettering, Medicare Part A covers inpatient hospital stays, and Part B covers physician services and outpatient care. MSK bills Medicare directly for these services, and Medicare pays its share. You are responsible for your Part A deductible (which applies per hospital stay), your Part B deductible, and coinsurance — typically 20 percent of the Medicare-approved amount for most outpatient services.

MSK is a teaching hospital and cancer research center, which means some of your care may involve clinical trials or research protocols. If you participate in a clinical trial, Medicare may cover the routine care costs associated with the trial, but you should ask MSK's clinical trials team whether any trial-specific costs fall to you. MSK's financial counselors can walk you through what Medicare will and will not cover for your particular treatment plan.

Medicare Advantage Plans and MSK Network Status

Medicare Advantage plans (Part C) contract with specific networks of hospitals and doctors. Memorial Sloan Kettering may be in-network for some plans and out-of-network for others, even if both plans are offered in the same area. If MSK is out-of-network for your plan, you may face much higher out-of-pocket costs or may need a referral to an in-network cancer center instead.

To find out whether MSK is in your plan's network, call the customer service number on your Medicare Advantage card or log into your plan's website. Have your member ID ready. Ask specifically whether Memorial Sloan Kettering Cancer Center is in-network for oncology services, because some plans may cover certain MSK services but not others. If you are considering switching plans during the annual enrollment period (October 15 to December 7), network access to MSK can be one factor in your decision.

What to Bring and How to Verify Coverage Before Your Visit

Before your first appointment at MSK, bring your Medicare card and any other insurance cards you carry. If you have both Original Medicare and a supplemental policy (Medigap), bring that card too — MSK will bill Medicare first, then your Medigap plan for the coinsurance you would otherwise owe. If you have Original Medicare and a Part D prescription drug plan, bring that card as well for any medications MSK prescribes.

Call MSK's financial services department ahead of time to verify your coverage. You can reach them at the main MSK number and ask to be transferred to financial counseling or patient financial services. They will review your Medicare coverage, estimate your out-of-pocket costs for your planned treatment, and explain any bills you may receive. This step can prevent surprises later and gives you time to ask about payment plans if costs are high.

Out-of-Pocket Costs and Financial information at MSK

Your out-of-pocket costs at MSK depend on your specific Medicare coverage. With Original Medicare, you typically pay your annual Part B deductible (currently $240, though this amount changes yearly), then 20 percent coinsurance for most outpatient services. Inpatient hospital stays involve a per-stay deductible and coinsurance after day 60. If you have a Medigap plan, it usually covers these costs, so you may pay little or nothing out of pocket.

MSK offers financial counseling and payment plans for patients whose bills exceed their ability to pay. If you receive a bill you cannot afford, contact MSK's patient financial services department to discuss options. They can sometimes reduce bills for uninsured or underinsured patients, though Medicare patients are generally expected to pay their Medicare-required costs. MSK also has social workers who can connect you with other resources, such as cancer-specific nonprofits that may help with copayments or travel costs.

Referrals and Prior Authorization Requirements

Original Medicare does not require a referral to see a specialist at MSK, so you can schedule an appointment directly if you have a physician's order for cancer treatment. However, some procedures or inpatient stays may require prior authorization from Medicare. MSK's scheduling and billing staff typically handle this authorization process on your behalf, but it is worth asking whether your planned procedure needs pre-approval when you call to schedule.

If you have a Medicare Advantage plan, check your plan documents for referral requirements. Some Medicare Advantage plans require a referral from your primary care doctor before you can see an oncologist at MSK. Others allow direct scheduling. Knowing this ahead of time prevents delays in starting treatment.

Frequently Asked Questions

Can I see any doctor at MSK with Medicare, or only certain ones?

Original Medicare covers any physician at MSK who accepts Medicare, which includes most MSK oncologists and surgeons. However, if you have a Medicare Advantage plan, your plan may limit you to certain doctors within MSK's network. Check your plan's provider directory or call your plan to confirm your doctor is covered.

What if I need a second opinion from MSK but I live out of state?

Original Medicare covers telehealth visits and in-person consultations at MSK locations in New York, New Jersey, and Connecticut. If you live outside these states, you can still have a telehealth consultation, though you should confirm with MSK that your Medicare plan covers remote visits. Some Medicare Advantage plans have geographic limits, so check your plan first.

Does Medicare cover clinical trials at MSK?

Medicare covers routine care costs associated with approved clinical trials, such as doctor visits, lab work, and imaging. However, some trial-specific costs may not be covered. Ask MSK's clinical trials team to explain what Medicare will cover before you enroll in a trial.

What happens if I switch from Original Medicare to a Medicare Advantage plan mid-treatment?

You can change plans only during the annual enrollment period (October 15 to December 7) or if you may have access to for a special enrollment period due to a life event. If your new plan does not include MSK in its network, you may need to switch to an in-network cancer center or pay out-of-network costs. Plan your switch carefully if you are in active treatment.

Will MSK bill me directly, or does Medicare handle the bill?

MSK bills Medicare directly for covered services. Medicare pays its share, and you receive a bill for your deductible and coinsurance. If you have a Medigap or Medicare Advantage plan, MSK may also bill those plans. You should receive an explanation of benefits from Medicare showing what was covered and what you owe.