Medicare covers immunotherapy treatment for cancer. Out-of-pocket costs will vary, depending on the Medicare plan a person has and whether or not they have supplemental insurance.

If a person has Original Medicare, the costs involve a 20% coinsurance after paying the deductible. For an individual with a Medicare Advantage plan, the costs include copays and deductibles, which vary with the plan.

This article provides an overview of immunotherapy, the types available, and what to expect during treatment. It also examines Medicare coverage and the costs associated with immunotherapy and lists some programs that can help people with limited means pay the costs.

Glossary of Medicare terms

  • Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
  • Premium: This is the amount of money someone pays each month for Medicare coverage.
  • Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
  • Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance 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.
Person getting immunotherapy treatment.Share on Pinterest
Image credit: golfcphoto/Getty Image

Medicare is the federal insurance program for people aged 65 years and older, as well as younger individuals with certain disabilities or conditions.

Each part of Medicare provides coverage for immunotherapy drugs.

Original Medicare

Original Medicare consists of Part A, which is hospitalization insurance, and Part B, which is medical insurance. Part A covers a hospital stay, meals, and any medications a person receives as an inpatient, including immunotherapy treatment.

Part B covers outpatient care, such as doctor visits and radiation treatment. People often receive intravenous immunotherapy in a doctor’s office or clinic, so many immunotherapy services fall under Part B. Medicare may also cover some oral immunotherapy drugs under Part B.

Medicare Advantage

Medicare Advantage, or Medicare Part C, is the alternative to Original Medicare. It provides the same benefits, including coverage for immunotherapy treatment during a hospital stay and in a doctor’s office.

Many Medicare Advantage plans also include prescription drug coverage, so if a person needs an immunotherapy drug that Part B does not cover, their Medicare Advantage plan may help pay for the drug.

Part D

Part D is Medicare prescription drug coverage available only to people enrolled in Original Medicare. It covers medications a person takes at home. Each plan has a list of covered drugs, which includes medications in the commonly prescribed classes.

Part D also covers some chemotherapy drugs, and it may cover an immunotherapy treatment that does not fall under Part B coverage. Part D plans also cover other drugs prescribed for people with cancer, such as those to relieve nausea or pain.

Medigap

Medigap is Medicare supplement insurance, and it is available to people with Original Medicare. It pays 50–100% of Original Medicare Parts A and B out-of-pocket costs, including for immunotherapy.

However, it does not help pay for medications that people take at home.

Healthcare professionals classify immunotherapy drugs into one of several classes based on how they interact with the immune system.

T-cell transfer therapy

T-cell transfer therapy improves the natural ability of T cells to fight cancer.

Healthcare professionals remove T cells from a person’s tumor and determine which ones are most active against the cancer.

Scientists will then cultivate cells in a laboratory before a healthcare professional injects them into the person’s vein.

Immune checkpoint inhibitors

These drugs block immune system checkpoints, which are structures that prevent an overly strong immune response. This action permits immune cells to respond more effectively against cancer.

Monoclonal antibodies

Monoclonal antibodies are immune system proteins that scientists create in a laboratory to bind to certain targets on cancer cells.

Some of these antibodies mark cancer cells to help the immune system recognize them, which increases the likelihood of cancer cell destruction.

Immune system modulators

Immune system modulators improve the body’s immune response when fighting cancer. Some of these drugs target the immune system generally, while others affect specific parts of it.

Treatment vaccines

Treatment vaccines help the immune system recognize the antigens in cancer cells and strengthen the body’s natural response against the cells.

Each part of Medicare has some out-of-pocket costs.

Part A

Part A costs in 2025 include a $1,676 deductible per benefit period and a 0% coinsurance for days 1–60 per benefit period.

Part B

Part B costs in 2025 include:

  • a $257 annual deductible
  • a 20% coinsurance
  • a $185 monthly premium, or higher depending on a person’s income

Medicare Advantage

Medicare Advantage plan costs include deductibles, copays, coinsurance, and monthly premiums. These expenses vary among plans.

Part D

Part D costs for immunotherapy treatment include deductibles, copays, coinsurance, and monthly premiums. These vary with the plan, the medications, and whether a person uses generic or brand-name drugs.

Medigap

The only Medigap cost is the premium, which may vary from under $100 to several hundred dollars per month.

Examples of costs

To provide an idea of immunotherapy expenses, the sections below show the costs for two medications, including the list price.

However, the price a person pays will depend on various factors, including their plan, their pharmacy, and their location.

Keytruda

According to the manufacturer, Merck, the list price of a 200-milligram dose of Keytruda, when received once every 3 weeks, is $11,337.36.

However, different people pay different amounts, depending on their plan. For example:

  • Medicare Advantage: Around 38% of people enrolled in a Medicare Advantage plan did not pay any out-of-pocket costs for this drug. Of those who did pay out-of-pocket costs, 80% paid between $0.01 and $925 per infusion, after paying the deductible.
  • Original Medicare: Around 80% of people enrolled in Original Medicare paid between $1,300 and $2,100 per infusion, after paying the deductible.

The manufacturer may offer financial help through the Merck Access Program, which a person can contact by calling 855-257-3932.

Neulasta

The manufacturer, Amgen, reports that the list price for a dose of Neulasta is $6,418.

The Amgen Support Co-Pay Program may provide financial assistance, and a person can contact this program by calling 888-264-2778.

Some programs may help people with limited means pay their out-of-pocket costs. These programs include:

  • Medicaid: Medicaid is a federal-state program that pays much of someone’s Medicare costs.
  • Medicare savings programs: Medicare savings programs provide assistance with various costs. Three of the programs help pay a monthly premium, while one program helps pay most out-of-pocket Medicare costs.
  • Medicare Extra Help: Medicare Extra Help provides approximately $5,900 worth of assistance per year in paying Part D costs.

Medicare resources

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

Medicare out-of-pocket costs for immunotherapy can be expensive. Medigap, plus several other programs, such as Medicaid and Medicare Extra Help, can provide assistance with the costs.

Understanding Medicare coverage and seeking assistance is essential to managing immunotherapy expenses effectively.