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Does Medicare Cover Cancer Screenings, Chemo and Radiation?

Updated: Oct 6, 2020

As you age, there’re a lot of different types of cancers that you should be aware of. It’s without a doubt that one of the most important measures you can take is preventative screenings.

If you’re unfortunately diagnosed with cancer, chemotherapy and radiation may be part of your treatment plan.

Medicare provides coverage for various cancer-related screenings and health care services, but what cancer screens does it actually cover?

Medicare covers a vast variety of preventative screenings that are related to different types of cancer which include:-

  • Breast Cancer

  • Cervical Cancer

  • Prostate Cancer

  • Lung Cancer

  • Colorectal Cancer

However the exact method of how each screening is covered, and the frequency of how often you may get them varies. Along with this, the coverage is also dependent on you meeting specific conditions. The preventative screenings covered by Medicare are mentioned below.

Medicare covers two different types of mammogram for Breast Cancer.

  • A screening mammogram is covered at no cost once every 12 months for women over age 40 that have Medicare and go to a physician that accepts Medicare assignment.

  • A diagnostic mammogram is also covered if it’s medically necessary. Frequency of this mammogram may vary based on your individual situation, and Medicare will cover 80% of the cost while you are responsible for 20% and the Part B deductible.

For Cervical Cancer, Medicare covers a Pap Smear and a Pelvic Exam (including clinical breast exam) every 24 months for most women and every 12 months if you’re considered high-risk for cervical or vaginal cancer, or if you’re of child bearing age and had an abnormal Pap smear in the last 36 months.

For Prostate Cancer, Medicare covers a prostate specific antigen (PSA) test and a DRE (digital rectal exam) test once every 12 months for men over age of 50.

Medicare Part B will cover a LDCT (low dose CT scan) for Lung Cancer if you meet certain conditions:

  • Age 55 or over

  • Written order for your doctor

  • Current smoker or quit within the last 15 years

  • History of Smoking 20 to 30 cigarettes per day for 30 years

  • Not exhibit any signs or symptoms of lung cancer

Along with all the above, Medicare covers a traditional screening colonoscopy plus other preventative tests for Colorectal Cancer. The coverage includes:-

  • Colonoscopy every 10 years, and once every 24 months if considered high-risk.

  • A FOBT (fecal occult blood test) every year at no cost if you’re aged over 50 and your doctor accepts Medicare.

  • A screening barium enema every 24 months if aged 50 over above and at a high-risk.

  • A multi-target stool DNA lab test once every 3 years if you’re aged between 50 to 85 and show no symptoms.

Medicare and Chemotherapy

Medicare does provide coverage for chemotherapy. Medicare Part A will provide coverage for you if you’re a hospital inpatient, and Medicare Part B will provide coverage if you receive chemotherapy in a hospital outpatient setting. However, if you receive treatment as an outpatient the cost you are accountable for will depend on the location. Chemotherapy treatments and prescription drugs may be covered under Medicare Part D as well.

Medicare and Radiation Therapy

Part A or Part B do provide coverage for radiation therapy. If you’re an inpatient and you’ll pay the Part A deductible and coinsurance. Whereas, Part B will provide coverage if you receive radiation therapy as an outpatient. You will have to pay 20% of the Medicare-approved amount and be responsible for the Part B deductible if you receive the therapy at a freestanding clinic.

Looking for some help?

We work as Independent Insurance Brokers, and have been appointed by many of the major insurance carriers. We can help you find the best policy for your individual situation.

For more details, please feel welcomed to contact us today at (540) 662-4432, and talk to one of our Insurance agents or simply visit our website to obtain more information.

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