Medicare plans include benefits that can help with leukemia treatment costs. Out-of-pocket expenses may apply, and additional support may be available.
Medicare covers many of the costs of care relating to leukemia. As with other cancers, doctors customize treatment options for people based on their medical history and type of cancer.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance 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:
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
- durable medical equipment (DME), such as 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.
Surgical options
Surgery plays a
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.
There are
- Bone marrow transplants: Bone marrow transplants utilize young cells from the bone marrow of a healthy person to replace bone marrow destroyed by cancer.
- Chemotherapy: These medicines aim to kill cancer cells. They can be in either pill form or can be administered intravenously.
- Immunotherapy: Immunotherapy uses a person’s immune system to track and attack cancer cells.
- Radiation therapy: This is a common treatment using high-energy waves to kill or damage cancer cells.
- Targeted therapy: Targeted therapy is a drug therapy that identifies and attacks certain types of cancer cells.
A person may choose to include alternative or complementary treatments, including diet changes, supplements, or natural extracts.
Medicare may not cover alternative treatment options, so it can be helpful to check plan documentation.
Read more about leukemia treatments.
Out-of-pocket costs apply to both parts A and B and include:
- deductibles
- copayments
- coinsurance
- excess charges
Most people do not pay a monthly premium for Part A. The standard premium for Part B in 2024 is $174.70 per month.
Premium amounts are updated annually.
Part A deductibles
The Part A deductible applies to each benefit period that starts the first day a person must stay in the hospital or skilled nursing facility (SNF).
The benefit period ends when an individual has not had any hospital or SNF care for 60 consecutive days. In 2024, the Part A deductible is $1,632.
There is no coinsurance for the first 60 days that a person stays in the hospital. For days 61–90, a person pays $408 per day. From day 91 onward, a person pays $816 per day.
Part B deductibles
For Part B, a $240 annual deductible applies in 2024. Once an individual has paid the deductible, Medicare pays 80% of eligible costs, and a person must pay the remaining 20% coinsurance.
Out-of-pocket costs for Medicare Advantage and Medigap plans will vary depending on the plan provider, region, or plan chosen.
Learn more about Medicare deductibles.
There are support options available to those who may need help with out-of-pocket costs.
Medicaid
Medicaid helps people with limited income and resources with their healthcare expenses. There are eligibility requirements and a person can check if they qualify by visiting the Medicaid website.
People who qualify for Medicaid or one of the savings programs mentioned below may also get Extra Help. This program helps pay for prescription drugs.
Medicare savings programs
A person who is not eligible for Medicaid may qualify for one of the Medicare savings programs (MSPs).
MSPs can help a person to pay for monthly premiums and out-of-pocket costs.
There are four different programs available, and an individual can check if they qualify by contacting their state’s Medicaid office.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Leukemia is a form of blood cancer. Medicare pays for many of the expenses needed to diagnose and treat the disease.
A person may be required to pay out-of-pocket expenses, but they may enroll in a Medigap policy to help cover these costs.
Individuals with limited income and resources may qualify for additional support from Medicaid, a Medicare savings program, or Extra Help.