Key takeaways:
Medicare covers medically necessary cancer treatment, including immunotherapy.
Which part of Medicare pays for the treatment depends on how you receive the drugs.
Out-of-pocket costs for immunotherapy include copays, coinsurance, and deductibles.
Immunotherapy is a cancer treatment that helps your body's immune system fight cancer cells. Breast, kidney, and lung cancer are among the conditions that can be treated with immunotherapy. Oncologists typically combine immunotherapy with other cancer treatments, such as chemotherapy, surgery, or radiation therapy.
If you have Medicare, many of the costs associated with immunotherapy may be covered by your insurance plan. Different parts of Medicare cover your treatment based on whether it’s inpatient, outpatient, or self-administered.
Does Medicare cover immunotherapy?
Yes, Medicare provides coverage for immunotherapy for cancer treatment that’s medically necessary. The way your immunotherapy is administered determines which part of Medicare will cover the treatment, which we discuss in the next section.
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How do the different parts of Medicare cover immunotherapy?
Your treatment plan will determine which part of Medicare covers your immunotherapy:
Part A covers inpatient immunotherapy during a hospital stay.
Part B covers outpatient immunotherapy in a doctor’s office or clinic.
Part D prescription coverage pays for self-administered immunotherapy at home.
Medicare Advantage, known as Part C, refers to private plans that replace Parts A and B. They have to meet or exceed Medicare’s coverage but typically have different out-of-pocket costs and healthcare networks.
What are the out-of-pocket costs you should consider?
While Medicare covers most immunotherapy costs, you may have out-of-pocket expenses such as deductibles, coinsurance, and copayments. What you’re responsible for paying for your immunotherapy can depend on the type of treatment you receive, the stage of cancer being treated, and your overall health.
Here’s the breakdown of Medicare costs when you access care:
Part A: If you’re hospitalized, you’ll pay a $1,676 deductible in 2025 for each benefit period (covered episode). In a calendar year, you may need to pay this deductible more than once. Coinsurance does not begin until after Day 60 of hospitalization. If necessary, Part A fully covers short-term stays at skilled nursing facilities.
Part B: The deductible is $257 in 2025. You’ll generally pay 20% of the Medicare-approved charge for most doctor services, outpatient therapy, and durable medical equipment after you meet the Part B deductible.
Part D: Outpatient prescription medication and supplies from a pharmacy are covered by your prescription drug plan through Part D. Your plan's coverage, the pharmacy you select, and your Medicare drug coverage phase determine how much you pay.
Medigap: If you have original Medicare, a Medicare supplement insurance plan known as Medigap can help you cover some or all of your Part A and Part B out-of-pocket costs. Original Medicare has no out-of-pocket limit.
What does Medicare cover? Original Medicare (Part A and/or Part B) and private Medicare Advantage plans both provide comprehensive insurance covering hospital stays, doctor visits, screenings, and more.
Medicare Advantage disadvantages: These private alternatives to original Medicare can provide added benefits, but they typically come with tighter healthcare networks and coverage restrictions.
Can’t afford your prescription medications? You can get help paying for your prescriptions by switching to generic options, using manufacturer discount cards, or taking advantage of patient assistance programs.
There’s also the cost of your plan to consider. Most people with Medicare don’t pay a Part A premium. The standard Part B monthly premium is $185 in 2025. People with higher incomes pay more than the standard Part B and Part D premiums.
Premiums for Medicare Advantage and Part D prescription plans vary. But Medicare Advantage plans have an out-of-pocket maximum, which is a limit on how much you spend in a year.
There are 10 standardized Medigap plans with benefits and premiums that vary.
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What is the process of getting immunotherapy covered by Medicare?
Once you determine that your healthcare professional and facility will accept your Medicare insurance, you may need prior authorization or other coverage approval for your care to be covered.
Can Medicare supplement insurance help cover immunotherapy?
Depending on your Medigap plan, all or some of your “excess charges” — another name for your Part A or Part B out-of-pocket costs — can be paid by your insurance supplement.
How long will Medicare pay for immunotherapy?
Your insurance will pay for immunotherapy as long as it’s medically necessary and recommended by your healthcare team.
How much does immunotherapy cost without insurance?
The cost of cancer immunotherapy depends on many factors, such as:
Type and stage of cancer being treated
Type of immunotherapy
How often you get immunotherapy
Cost per dose
Oncologists use several types of immunotherapies to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, and monoclonal antibodies. Prices can range from less than $1,000 to more than $400,000 per treatment.
For example, Yescarta — a type of immunotherapy that treats lymphoma — had a list price of more than $400,000 per infusion in 2023.
Types of immunotherapy
The table below shows different types of immunotherapies your healthcare professional may recommend.
Types of immunotherapy for cancer
| Type of immunotherapy | Purpose | Examples |
|---|---|---|
| Immune checkpoint inhibitors | Stop specific checks and balances that your body usually uses to keep your immune system from overacting |
|
| T-cell transfer therapy | Enable your immune cells to fight cancer better |
|
| Monoclonal antibodies | Help your immune system locate cancer cells so that your body can destroy them |
|
| Immune system modulators | Improve your immune system’s response to cancer |
|
| Treatment vaccines | Assist your immune system in identifying, finding, and eliminating cancer cells |
|
What other resources can help pay for immunotherapy?
Whether you have insurance, are underinsured, or don’t have coverage, some pharmaceutical companies have programs to help you pay for immunotherapy prescriptions if you have Part D coverage. Use this online tool to see if there’s a pharmaceutical assistance program for your cancer treatment.
Patient assistance programs (PAPs) may also provide free or discounted treatment. Examples of PAPs include:
In addition, you may be able to access immunotherapy by participating in cancer clinical trials. First, find a clinical trial that matches your diagnosis, stage, and treatment history. Then schedule an appointment to discuss your potential participation.
The bottom line
Medicare covers immunotherapy when it’s deemed medically necessary. The part of Medicare that will cover your treatment depends on how you’re receiving immunotherapy. Check your plan or speak with a Medicare representative to get specific information about your coverage. Also, expect to pay out-of-pocket costs, such as copays, coinsurance, and deductibles. You may be able to get help with medication costs through a Medigap plan (if you have original Medicare), patient assistance programs, pharmaceutical assistance programs, and clinical trials.
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References
Bosworth, A., et al. (2023). Changes in the list prices of prescription drugs, 2017-2023. U.S. Department of Health and Human Services.
Cancer Research Institute. (n.d.). Cancer clinical trials.
Medicare.gov. (n.d.). Compare Medigap plan benefits.
Medicare.gov. (2025). Medicare coverage of cancer treatment services.
