Does Medicare Cover Clinical Trials?

A clinical research study, also known as a clinical trial, helps doctors find better ways to treat and prevent certain diseases, such as cancer.

The goal of clinical trials is to evaluate if a new test or treatment works and is safe.

Clinical trials also help medical professionals learn how to prevent disease, treat symptoms and minimize side effects.

People participate in clinical trials for various reasons.

Patients with a serious illness or disease may join a research study to potentially receive the latest available treatment, as well as personalized care from the research staff.

Before you join a clinical trial, a doctor, nurse or other professional on the research team will explain the study’s purpose and what to expect during the trial.

You will be given a consent form to read. Make sure to ask questions about any aspect of the clinical trial or consent form that you don’t understand.

Even if you decide to participate in a clinical trial and sign the consent form, you can always change your mind and stop participating.

Original Medicare (Part A and Part B) pays for routine costs in certain qualifying clinical research studies.

Sometimes a clinical research study includes services Medicare doesn’t cover. For example, Medicare will not cover research-related costs.

Medicare will not cover the new item or service being tested unless it’s normally covered by Medicare outside of clinical trials.

For example, Medicare would pay for chemotherapy-related medical care — but not the new chemotherapy drug itself.

However, according to the Medicare & Clinical Research Studies booklet, the new treatment being tested is often provided for free by the study sponsor.

Different parts of Medicare may pay for different costs associated with your participation in a clinical trial.

Finally, Medicare will not cover additional tests and services conducted only for data collecting purposes.

For example, if Medicare usually only covers a yearly EKG test but the clinical trial conducts monthly EKGs, Medicare will not pay for these extra tests.

If you’re in a Medicare Advantage plan, you can get the same coverage for clinical research studies as someone in Original Medicare.

If you’re worried about paying for services not covered by Medicare, talk to the clinical trial research staff and see if they can help.

Your routine care costs are generally covered by Medicare if the clinical trial is funded at least in part by the federal government.

You can visit ClinicalTrials.gov to see a list of government and private studies across the country. The website provides details about a trial’s purpose, who can participate, locations and contact information.

You can also join the National Registry of Research Volunteers at ResearchMatch.org.

This initiative is funded by the National Institutes of Health to connect people who are searching for research studies with researchers looking for people to participate in their studies.

It is a free, secure registry.