- Some Medicare plans offer coverage for preventative screenings for testicular cancer.
- If you’ve been diagnosed with testicular cancer, your coverage for treatment will depend on your Medicare plan, cancer stage, and treatment plan.
- Always confirm coverage before beginning a treatment plan, and if the recommended treatment isn’t covered, ask your doctor if there are other, equally as effective options that may be covered.
Medicare has different plans that can help cover most costs that come along with diagnosing, preventing and treating testicular cancer.
Read on to learn what Medicare covers.
Some Medicare plans offer preventative screenings for testicular cancer and other yearly wellness visits.
If you’ve been diagnosed with testicular cancer, the type of treatment you’ll need will depend on which stage the cancer is in:
- In stage 1, the cancer is limited to the testicle.
- In stage 2, cancer has spread to lymph nodes in the abdomen.
- In stage 3, cancer has spread to other parts of the body. Stage 3 cancer commonly spreads to the bones, brain, lungs, and liver.
Testicular cancer may be treated with surgery, chemotherapy, or radiation therapy. The cost of testicular cancer treatment depends on which Medicare plan you have. You may need one or more of the following treatment options depending on the stage of your cancer.
Talk to your doctor about which treatment may be necessary if you have testicular cancer and if those treatments are covered by your Medicare plan.
- Chemotherapy treatments if you’re receiving inpatient care. Chemotherapy is often recommended by itself or in addition to lymph node removal surgery.
- Radiation therapy if you’re receiving inpatient care. Radiation is often recommended for people with a seminoma, or slow-growing type of testicular cancer.
- Surgery that happens as an inpatient (including costs for a surgeon, anesthesiologist, operating room fees, pathologist, equipment, and medicines). Radical inguinal orchiectomy is a common surgery for people with testicular cancer.
- Inpatient hospital stays, including for cancer treatment you receive as an inpatient.
- Nursing facility care after a qualified 3 consecutive days as an inpatient.
- Rehabilitation services for at-home care including physical therapy, occupational therapy, and speech-language pathology therapy.
- Hospice care.
- Any blood work, including for diagnosis, that you have done while receiving inpatient care.
- Some clinical research costs as an inpatient.
Services covered under Part A may require copayments or deductibles. This is how much Part A costs in 2020.
- Outpatient chemotherapy treatments, either at a doctor’s office or a hospital.
- Visits to the oncologist, urologist, or any other doctor. Confirm that the doctor accepts Medicare prior to your appointment to help avoid unexpected costs.
- Radiation treatments that are done in an outpatient clinic.
- X-rays and CT scans. Biopsies are also a common procedure that would be covered through Part B for diagnosing testicular cancer.
- Durable medical equipment such as a wheelchair or feeding tube.
- Surgeries that are done as an outpatient.
- Therapy and other mental health services.
- Prevention screening and wellness checks for cancer, depression, and diabetes.
You may have to pay copayments, deductibles, or coinsurance that apply to each service. Services may cost more if your doctor doesn’t accept Medicare. This is how much Part B costs in 2020.
Medicare Advantage plans include the same coverage as Part A and Part B, along with some prescription drug coverage. They provide additional services and generally have a higher monthly premium than original Medicare plans, but may have lower copayments or deductibles, or may provide additional coverage.
To find out specifics about your coverage for testicular coverage, call your provider and speak to a representative.
Medicare Part D plans help cover prescription drug costs that aren’t covered under Part B. Most prescription medications and some chemotherapy treatments are covered under Part D.
Part D plans are required to cover all drugs that fall into six specific drug classes. Many of these drugs are often used to help treat cancer:
- Antineoplastics are used in chemotherapy to kill cancer cells.
- Antidepressants are used to treat depression.
- Antipsychotics are used to manage psychosis.
- Anticonvulsants are used to treat seizures.
- Immunosuppressants for those receiving organ transplants.
- Antiretrovirals are used to manage HIV/AIDS.
Medications costs will vary depending on the type of medication you take, which Medicare plan you have, and where you get your medication from. You may have deductibles or out-of-pocket costs to pay.
Your coverage will also depend on whether your doctor takes Medicare. To find out if a doctor is covered, you can call the doctor’s office or your Medicare provider and ask before your appointment. You can also use the Physician Compare resource on the Medicare website if you need help finding a doctor that takes Medicare.
Medicare can help cover a lot of the costs for treating testicular cancer, and some Medicare plans offer preventative screenings for testicular cancer and other yearly wellness visits. Talk to your doctor if you notice any unusual changes in your body and think you may need treatment.