Averting expensive errors in Medicare is critical.
Drugs like chemotherapy, typically given in a physician’s office or as an outpatient in a hospital, aren’t included in Part D drug plans.
However, Medicare Part B encompasses chemotherapy treatments. If treatments are not self-administered, Part B, the medical insurance part, provides payment for these.
On the Medicare.gov website, the Medicare Plan Finder indicates that Medicare Advantage plans do include coverage for chemotherapy treatments.
Each policy stipulates its individual rules for coverage and shared costs. While they are obliged to handle medically necessary treatments, there is variation in the method of covering these services. Under Medicare Advantage plans, chemotherapy often requires “pre-approval” or prior authorization. The vast prevalence of these plans levy a 20% coinsurance for such treatments.
