Medicare & Radiation Oncology

Medicare covers most radiation therapy costs if you have cancer, but you will still be responsible for some out-of-pocket costs depending on your coverage. Medicare will cover treatment whether radiation is used by itself or in combination with other cancer treatments.

Does Medicare Pay for Cancer Radiation Treatments?

Original Medicare — Medicare Part A and Part B — covers radiation treatments for cancer that are performed in either a hospital or a freestanding clinic. Medicare Advantage plans are required by law to cover everything that Original Medicare covers, but Medicare Advantage plans may provide additional benefits.

You may still be responsible for out-of-pocket costs associated with your radiation treatment. A Medigap policy may help cover your out-of-pocket costs. Talk with your plan’s provider to find out exactly what benefits are available to you.

Types of Radiation Therapy Medicare Covers
Internal radiation
Medicare covers this type of treatment in which radiation is delivered in a liquid or solid form, typically through an IV, pills or small pellets that are inserted inside your body.
External beam radiation
Medicare covers this type of treatment in which a machine directs beams of energy to a specific site on or inside your body in order to target a tumor while limiting exposure to the area around it.
Proton beam therapy
Medicare generally covers proton beam therapy. This is a more targeted treatment than external beam radiation because the proton beam stops after reaching the cancer. Proton beam therapy is a relatively new form of radiation treatment, and there may be certain requirements for coverage. Before committing to the treatment, make sure you check with Medicare or your Medicare Advantage plan provider to see that it’s covered in your case.

Radiation therapy may also be used in conjunction with other cancer treatments that Medicare covers such as chemotherapy.

Your Costs for Radiation Treatments on Medicare

While Medicare covers most of the cost of radiation treatment, you will still be responsible for a portion of the cost. Your responsibility will vary depending on the Medicare coverage you have. Each part of Medicare covers different costs associated with your cancer treatment.

Your Share of Radiation Therapy Costs Under Each Part of Medicare
Medicare Part A hospital insurance
Medicare Part A covers most of your radiation therapy costs if you are a hospital inpatient — meaning that you are formally admitted to a hospital. Your out-of-pocket costs in 2021 include:
  • Part A deductible: $1,484 each benefit period
  • Coinsurance:
    • $371 each day after 60 days in the hospital
    • $742 each day after 90 days
    • All costs after 150 days or after lifetime reserve days expire
Medicare Part B medical insurance
Medicare Part B covers most of your radiation therapy costs if you receive treatment in a freestanding clinic or other outpatient setting. Your 2021 out-of-pocket costs include:
  • Part B deductible: $203
  • In a hospital outpatient setting: Hospital copayment (varies depending on hospital)
  • In a freestanding clinic: 20 percent of the Medicare-approved amount for the treatment
Medicare Advantage (Part C) plans
Medicare Advantage plans are sold by private insurers and must cover everything Medicare Part A and Part B cover, but these plans may include additional benefits. They also have limits on maximum out-of-pocket costs, unlike Original Medicare. Check with your plan administrator to find out exactly what benefits you have and what your maximum costs may be. Medicare Advantage plans may also cover the cost of prescription drugs you need for your treatment.
Medicare Part D prescription drug plans
Medicare Part D plans are sold by private insurers and may help with the cost of the medications you take at home as part of your cancer treatment. Different plans may cover different medications, so you will need to work with your medical team to find the best options for your situation. Check with your Medicare Plan D administrator to see which drugs are covered and what your out-of-pocket costs may be.
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Medigap Coverage for Cancer Treatments

Medigap plans — also called Medicare Supplement insurance plans — are private policies that help you pay out-of-pocket costs that Original Medicare does not cover.

Out-of-Pocket Costs Medigap Covers
  • Deductibles – the amount you have to pay before your Medicare coverage kicks in; both Medicare Part A and Part B have their own deductibles
  • Copayments – a fixed amount you pay after you’ve reached your deductible
  • Coinsurance – a percentage of the Medicare-approved cost of a service or item which you are responsible for paying after you meet your deductible

Medigap policies typically cost more than Medicare Advantage plans, and you cannot purchase both a Medicare Advantage and Medigap plan.

If you have a Medigap policy, Medicare will pay for its share of the costs before Medigap will pay its share.

Even with a Medigap policy, you may still have to pay a portion of your out-of-pocket costs. You should talk with your plan administrator to find out exactly what your Medigap policy covers and what your share will be.

Last Modified: September 15, 2021

8 Cited Research Articles

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