Does Medicare Cover Chemotherapy?
Direct Answer: Yes. Medicare covers chemotherapy. The exact coverage rules depend on whether the chemotherapy is administered intravenously at a clinic (Medicare Part B) or taken as an oral prescription pill at home (Medicare Part D).
Part B vs. Part D Chemotherapy Coverage
1. Outpatient Chemotherapy Infusions (Part B)
Chemotherapy administered by IV, infusion, or injection at a doctor's office, outpatient clinic, or hospital setting is covered under Medicare Part B.
- Original Medicare: Pays 80% of the Medicare-approved amount after your Part B deductible. You pay 20% coinsurance (unless covered by Medigap).
- Medicare Advantage: Requires copayments or coinsurance up to your plan's annual maximum out-of-pocket limit. Prior authorization is usually required.
2. Oral Chemotherapy Pills & Anti-Nausea Drugs (Part D)
Self-administered oral chemotherapy tablets, targeted oral therapies, and prescribed anti-nausea medications are covered under Medicare Part D prescription drug plans.
- Part D drug coverage includes an annual out-of-pocket spending cap ($2,000 in 2026).
- Check your plan's formulary to verify drug tier, prior authorization, and preferred pharmacy pricing.
Questions to Ask Your Oncology Care Team
- Is my chemotherapy regimen billed through Part B or Part D?
- Has the clinic submitted prior authorization for my chemotherapy drugs?
- Are financial assistance or copay assistance foundations available if out-of-pocket costs are high?
Free & Independent Counseling
Speak With a State Health Insurance Counselor (SHIP)
HIICAP (Health Insurance Information, Counseling and Assistance Program) provides free, unbiased, one-on-one Medicare counseling. SHIP counselors do not sell insurance or receive commissions.