There are benefits included in Medicare plans that can help with treatment costs relating to leukemia. Out-of-pocket expenses may apply, but there may be additional support available.
Medicare covers many of the costs of care relating to leukemia. As with other cancer, doctors customize treatment options for people based on their medical history and type of cancer.
In this article, we discuss the different treatments for leukemia, what Medicare covers, and other options that may be available.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Original Medicare has two parts that each provide coverage for care received in different settings.
Medicare Part A
Medicare Part A is sometimes called hospital insurance and covers inpatient hospital stays, including cancer treatment a person receives while in the hospital.
Part A also pays for skilled nursing facilities, hospice, and home healthcare. Home healthcare can include:
- physical therapy
- speech and language therapy
- occupational therapy
- skilled nursing care
A person enrolled in an eligible clinical research study may also have some costs covered by Part A.
Medicare Part B
Medicare Part B is sometimes called medical insurance. This part of Medicare pays for medically necessary, cancer-related treatments and services a person may need outside the hospital.
This can include:
- doctor visits
- chemotherapy drugs administered intravenously in an outpatient clinic or doctor’s office
- some oral chemotherapy
- durable medical equipment (DME) like wheelchairs or walkers
- mental health services
- nutritional counseling
- radiation treatment
In some instances, Medicare Part B will cover the cost of a second opinion for surgery. This happens if the surgery is not an emergency. They may cover a third opinion if the first and second opinions differ.
Medicare Part D
Medicare Part D, also known as a prescription drug plan (PDP), covers outpatient prescription drugs. Private insurance companies administer these plans.
Some chemotherapy drugs that are not covered by Part B, may be covered under a PDP, as well as prescribed pain relief and anti-emetics.
Surgery plays a limited role in treating leukemia since blood carries the disease throughout the body.
An individual may get a central venous catheter, which is a flexible tube that is inserted into a large vein, making it easier to administer chemotherapy. This is an inpatient surgical procedure that is covered by Part A.
A person may also have a biopsy of the lymph nodes or bone marrow that can help diagnose leukemia. The biopsy is an outpatient procedure and is covered by Part B.
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