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Commonly Searched Questions
Does Medicare Cover Cancer Surgery?
- Medicare coverage generally includes many medically necessary surgical procedures including surgery for cancer treatment. Inpatient surgery would be covered by Medicare Part A (hospital insurance) and outpatient surgery would be covered by Medicare Part B (medical insurance).
- Medicare Advantage plans also generally cover cancer treatment surgery. Medicare Advantage is Medicare coverage offered by private insurance companies contracted with Medicare. Medicare Advantage plans cover everything that Medicare Part A and Part B cover. You must continue to pay your Part B premium with a Medicare Advantage plan.
For more information, visit Medicare.gov, or call 1-800-MEDICARE.
Does Medicare Cover Chemotherapy?
Does Medicare Cover 100% of chemotherapy?
Yes. Medicare Part A and Part B cover chemotherapy if you have cancer.
- Medicare Part A (Hospital Insurance) covers it if you are staying at a hospital.
- Medicare Part B (Medical Insurance) covers it if you’re a hospital outpatient or a patient in a doctor’s office or freestanding clinic. You will pay a Part B copayment in a hospital outpatient setting.
- For chemotherapy given in a doctor’s office or freestanding clinic, you pay 20% of the Medicare-Approved Amount and any Part B deductible required.
What Doesn’t Medicare Cover?
Medicare doesn’t cover:
- Room and board in assisted living facilities.
- Adult day care.
- Long-term nursing home care.
- Medical food or nutritional supplements (except enteral nutrition equipment).
- Services that help you with activities of daily living (like bathing and eating) that don’t require skilled care
Visit Medicare.gov/Cancer Treatment Services or call 1-800-633-4227). TTY users can call 1-877-486-2048
Does Medicare Cover Cancer Treatment?
Does Medicare Cover Cancer?
Yes. Medicare covers many of the costs of cancer. Work with your doctor’s office to get the most payment help possible.
Medicare Part A (Hospital Insurance) Covers:
- Inpatient hospital stays, including cancer treatments you get while
you’re an inpatient in the hospital. You may be in a hospital and still be considered an outpatient (also called observation status). - Skilled nursing facility care (following a related 3-day hospital stay).
- Home health care (like rehabilitation services for physical therapy, speech-language pathology therapy, occupational therapy, or skilled nursing care).
- Blood tests
- For breast cancer patients, surgically-implanted breast prostheses after a mastectomy, if the surgery takes place in an inpatient setting.
- Hospice care.
Medicare Part B (Medical Insurance) Covers:
Many medically necessary cancer-related outpatient services and treatments, but for some services, you must meet certain conditions. You may be in a hospital and still be considered an outpatient (observation status).
Some preventive services for people who are at risk for cancer.
For more information, visit Medicare.gov, or call 1-800-633-4227.
Does Medicare Cover Immunotherapy?
Medicare covers immunotherapy. Original Medicare and Medicare Advantage plans cover immunotherapy as a cancer treatment if a Medicare-approved doctor determines that immunotherapy is medically necessary.
Original Medicare covered immunotherapy under Part A if the therapy is given in an inpatient setting and under Part B if it’s received on an outpatient basis.
Please call 1-800-MEDICARE or 1-800-633-4227 for assistance.
Please call 1-800-MEDICARE or 1-800-633-4227
Does Medicare Cover Breast Implants or Post Surgery Bras?
Medicare may cover breast implants after you have surgery.
- Medicare Part B (Medical Insurance) covers some external breast prostheses (including a post-surgical bra) after a mastectomy.
- Part A covers surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting. Part B covers the surgery if it takes place in an outpatient setting.
Does Medicare Cover Cancer Radiation Treatment?
Yes. Medicare covers cancer radiation treatment for most Medicare recipients.
- Medicare Part A (Hospital Insurance) covers radiation therapy for hospital inpatients.
- Medicare Part B (Medical Insurance) covers this therapy for outpatients or patients in freestanding clinics.
How Do I Claim Payment From Medicare?
How Do I Request Payment From Medicare?
To request payment from Medicare, complete this form.
What Should I Send?
SEND ONLY THE COMPLETED FORM to your Medicare Administrative Contractor plus a copy of your itemized bill and any supporting documents. Make a copy of the entire claim submission for your records and allow at least 60 days for receipt and processing.
Who Should I Send It To?
Once you have all of your documents together, mail them to your Medicare Administrator.
Where Should I Send It?
To find the address of the Medical Administrator for the state in which you had medical service, search the Medicare Administrative Contractor Address Table that starts on page 7 of this document.
How do I Call Medicare For Help?
Medicare’s phone number is 1.800.MEDICARE or 1-800-633-4227
Do not hesitate to call the Medicare HOTLINE if you need help.
To request payment from Medicare, complete this form.