Does Medicare cover chemotherapy?

What does Medicare cover for chemotherapy?

Medicare covers chemotherapy if you have cancer. Chemotherapy is a drug treatment that kills fast-growing cells, including cancer cells, in your body. Which part of Medicare pays depends on where you get it:

• Medicare Part A (Hospital Insurance) covers chemotherapy if you're a hospital inpatient. To be an inpatient, you're admitted to a hospital that accepts Medicare with a doctor's order saying you need inpatient care.
• Medicare Part B (Medical Insurance) covers chemotherapy if you're a hospital outpatient or you get it in a doctor's office or a freestanding clinic.

What do I pay for chemotherapy with Original Medicare?

After you meet the Part B deductible ($283 in 2026), you typically pay 20% of the Medicare-approved amount for chemotherapy you get in a doctor's office, a freestanding clinic or a hospital outpatient setting. If you get chemotherapy in a hospital outpatient setting, your copayment won't be more than the Part A inpatient deductible amount ($1,736 in 2026). Medicare.gov notes you may pay more for care in a hospital outpatient setting than for the same care in a doctor's office that's independent from the outpatient department.

As a hospital inpatient, Part A costs are set for each benefit period: in 2026 you pay the $1,736 Part A deductible for days 1 to 60, then $434 a day for days 61 to 90. Part B generally covers 80% of the Medicare-approved amount for doctors' services you get while you're in the hospital. What you owe also depends on other insurance you have, what your doctor charges, whether your doctor accepts assignment, and the type of facility.

Which cancer drugs does Medicare cover?

Medicare Part B covers a limited number of outpatient drugs, usually ones you wouldn't give yourself. For cancer care, Part B covers:

• Most injectable and infused drugs when a licensed medical provider gives them.
• Some cancer drugs you take by mouth, if the same drug is available in an injectable form or is a prodrug of the injectable drug (an oral form that breaks down into the same active ingredient).
• Anti-nausea drugs you take by mouth, if you take them before, during or within 48 hours of chemotherapy, or as a full replacement for an intravenous anti-nausea drug.
• Medicare drug coverage (Part D) covers many drugs Part B doesn't. Every Medicare drug plan must cover most drugs in certain protected classes, including drugs to treat cancer, so check the plan's drug list (formulary).

Does Medicare Advantage or Medigap change what I pay for chemotherapy?

Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, and Medicare says these plans can't charge more than Original Medicare for certain services, including chemotherapy. A plan may require approval (prior authorization) first and may ask you to use doctors in its network, so check the plan's rules. See how Medicare Advantage differs from Original Medicare.

With Original Medicare, a Medicare Supplement Insurance (Medigap) policy helps pay your Part A and Part B out-of-pocket costs for covered services, like copayments, coinsurance and deductibles. You can't use Medigap to pay costs in a Medicare Advantage plan.

Does Medicare cover chemotherapy in a clinical trial?

Medicare covers some costs, like office visits and tests, in certain clinical research studies, such as a study testing how well a new cancer drug works. You may pay 20% of the Medicare-approved amount, depending on the treatment you get, and the Part B deductible may apply. See what Medicare covers in clinical trials.