Does Medicare Cover Lung Cancer Treatment?
This article was updated on: 09/12/2018
If you’ve been diagnosed with lung cancer, your doctor and treatment team will work together with you to develop a lung cancer treatment plan. According the American Cancer Society, treatment will be based on the type and stage of your cancer and on your overall health. It’s important to discuss your lung cancer treatment options thoroughly with your doctor so you understand the risks, benefits, and potential side effects before you decide how to proceed. Your Medicare benefits may cover a portion of the costs of hospitalization, doctor visits, and medication associated with your lung cancer diagnosis.
What kind of lung cancer treatment is available?
The American Cancer Society notes that your lung cancer treatment will likely involve one or more of the following therapies.
In some cases, surgery is used to treat or even cure lung cancer. Your surgeon will remove the cancer and any surrounding lymph nodes that may be affected. Surgery carries a risk of bleeding, infection, and pneumonia, and recovery can take anywhere from a few weeks to a few months. The most common surgical procedures are:
- Pneumonectomy, or removal of the entire lung
- Lobectomy, or removal of the affected lobe of the lung.
- Resection, or removal of a wedge- or sleeve-shaped portion of a lobe of the lung or airway
Chemotherapy is a common lung cancer treatment because it actually kills cancer cells. It is often used before surgery to shrink the size of a tumor or tumors, and after surgery to destroy any remaining cancer cells. Chemotherapy is either given in a series of treatments through your vein (intravenously) or in pill form.
Chemotherapy is often associated with unpleasant side effects such as:
- Hair loss
- Nausea, vomiting, diarrhea
- Blood disorders
- Mouth and throat sores
Some chemotherapy side effects can be helped with prescription medications.
Radiation therapy uses high-powered radiation beams to kill cancer cells. It may be delivered with a machine outside your body or placed inside the body in the form of little seeds or pellets (brachytherapy). In people with advanced lung cancer, radiation therapy can help relieve pain. This lung cancer treatment can also cause extreme fatigue, and skin conditions such as peeling, burning, itching, or blistering.
Targeted prescription drug therapy
Depending on the type of lung cancer you have, your doctor may recommend treatment with prescription drugs. These drugs work in different ways; some target the blood vessels that cancer cells need to grow, while others may target gene changes that affect tumor growth. In many cases, your doctor will recommend a combination of chemotherapy and prescription drugs for your lung cancer treatment.
The American Cancer Society reports that depending on the type of prescription drugs you are given, you may have side effects such as:
- Mouth sores
- Nausea, vomiting, diarrhea
- Loss of appetite
- Skin problems
According to the American Cancer Society, palliative care is a medical specialty that works to alleviate cancer symptoms as well as minimize any side effects from the lung cancer treatment you receive. Palliative care is intended to increase comfort rather than cure your illness. Also known as supportive care, palliative treatments might include relieving fluid buildup around the lungs or opening a blocked airway, for example. Palliative care may be part of hospice care, which may be covered under Medicare Part A.
How does Medicare cover lung cancer treatment?
If you are enrolled in Original Medicare (Part A and Part B), your allowable charges, including doctor visits, tests, surgeries, chemotherapy, and radiation therapy may be covered. If you get lung cancer treatment as an inpatient in the hospital or a nursing home, generally Part A covers for your care, while Part B covers most treatment you receive on an outpatient basis.
While there is no prescription drug coverage under Original Medicare, Part B does cover most intravenous (IV) medications administered by your doctor or other health-care provider, such as chemotherapy drugs. Prescription drugs you buy at a pharmacy and take at home are generally not covered under Part B.
However, if you are enrolled in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, you may have coverage for most prescription drugs your doctor may order for lung cancer treatment or to manage side effects. Consult your plan’s formulary (list of approved prescription drugs) for details. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
If you have concerns about Medicare coverage for lung cancer treatment, I am available to answer your questions. You can even request an email with personalized information or schedule a telephone call by clicking one of the links below. To view a list of plans in your area you may qualify for, click the “Compare Plans” button.