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Florida has one of the highest cancer incidence rates in the United States, with over 140,000 new diagnoses per year. For Medicare beneficiaries facing a cancer diagnosis, understanding what your coverage includes — and where the gaps are — is not just a financial question. It directly affects which oncologists you can see, which cancer centers you can access, and whether unexpected medical bills add financial stress to an already difficult situation.
Original Medicare (Parts A and B) covers a broad range of cancer-related services:
| Service | Medicare Part | Your Cost Share |
|---|---|---|
| IV chemotherapy (outpatient infusion) | Part B | 20% coinsurance after $257 deductible |
| Oral chemotherapy drugs | Part D | Formulary tier cost sharing; $2,000 annual cap |
| Radiation therapy (outpatient) | Part B | 20% coinsurance after deductible |
| Cancer surgery (inpatient hospital) | Part A | $1,676 deductible per benefit period; $0 days 1–60 |
| Cancer surgery (outpatient) | Part B | 20% coinsurance after deductible |
| Inpatient hospital stay for cancer treatment | Part A | $0 days 1–60; $419/day days 61–90 |
| Oncologist office visits | Part B | 20% coinsurance after deductible |
| Diagnostic imaging (CT, MRI, PET scans) | Part B | 20% coinsurance after deductible |
| Clinical trial routine costs | Part A and/or Part B | Standard cost sharing applies |
How your chemotherapy is administered determines which part of Medicare pays for it — a distinction that matters significantly for your out-of-pocket costs.
Intravenous chemotherapy administered in a hospital outpatient department or oncologist's infusion suite is covered under Medicare Part B. After the annual Part B deductible ($257 in 2026), you pay 20% coinsurance. There is no annual out-of-pocket cap under Part B unless you have a Medigap supplement plan. This is the coverage category that creates the most financial risk for cancer patients without supplemental coverage.
Many newer cancer treatments are taken as pills or capsules rather than through an IV. These oral chemotherapy drugs are covered under Medicare Part D as prescription drugs. Under the IRA's 2025 reforms, all Part D out-of-pocket costs are now capped at $2,000 per year. For many oral cancer medications — which can cost $15,000–$30,000 per month at retail price — this cap is transformative. Once you reach $2,000 in covered Part D costs for the year, your plan pays 100% for the rest of the year.
Consider a common scenario: a Florida Medicare beneficiary is diagnosed with lung cancer and undergoes 6 cycles of combination chemotherapy, each costing approximately $15,000 for the infusion session. Total infusion cost: $90,000. Under Original Medicare alone, that beneficiary owes $18,000 in coinsurance — in addition to any hospitalizations, imaging, or ancillary services.
Medigap Plan G covers 100% of the Part B coinsurance after you have met the $257 annual Part B deductible. With Plan G, your exposure on that same $90,000 chemotherapy course is just $257 — the deductible. The monthly premium for Plan G in Florida typically ranges from $120 to $250 depending on age and insurer, making it an exceptional value for anyone who faces substantial medical treatment.
Medicare covers the routine costs associated with participation in qualifying clinical trials. Routine costs include services that would be covered whether or not you were in a trial — such as standard lab tests, imaging, doctor visits, and hospitalizations required for your condition. The experimental drug or intervention itself is typically provided by the trial sponsor at no cost to you.
To qualify for Medicare clinical trial coverage, the trial must be a Phase I, II, III, or IV cancer clinical trial and must meet specific Medicare criteria. Most trials sponsored by the National Cancer Institute (NCI) or conducted at NCI-designated cancer centers automatically qualify. Florida has several such centers, including Moffitt Cancer Center and the University of Miami Sylvester Comprehensive Cancer Center.
For most Florida Medicare beneficiaries who want maximum protection against cancer treatment costs, Original Medicare paired with Medigap Plan G is the gold standard. Plan G covers:
The only gap Plan G does not cover is the annual Part B deductible ($257 in 2026). That makes Plan G effectively a zero-coinsurance plan for cancer treatment services covered under Part B.
Florida is home to several nationally recognized cancer treatment centers, all of which accept Original Medicare:
With Original Medicare + Medigap, you can see any of these providers without a referral and without network restrictions. With Medicare Advantage, you must verify the specific center is in your plan's network before receiving care.
Medicare Advantage plans cover all medically necessary cancer treatments that Original Medicare covers, but there are important practical differences. Prior authorization is routinely required for chemotherapy, radiation, and other cancer services under MA plans. Your oncologist must be in the plan's network, and referrals from your primary care physician may be required to see specialists.
If you are already enrolled in a Medicare Advantage plan and receive a cancer diagnosis, you have options. During the Medicare Advantage Open Enrollment Period (January 1–March 31), you can switch from an MA plan back to Original Medicare once per year. If you make this switch within your Medigap Open Enrollment Window (the first 6 months after your Part B start date), you have guaranteed issue rights for a Medigap policy. Outside that window, medical underwriting may apply in Florida.
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Does Medicare cover chemotherapy?
Yes. Medicare covers chemotherapy under both Part B and Part D. IV chemotherapy administered in a hospital outpatient setting or oncologist's office is covered under Part B, with 20% coinsurance after the deductible. Oral chemotherapy pills are covered under Part D as a prescription drug, subject to formulary tier cost sharing. With the 2025 IRA changes, oral chemo costs are now capped at $2,000 per year under Part D.
What is the financial risk of cancer treatment under Original Medicare without Medigap?
Under Original Medicare Part B, you pay 20% coinsurance for outpatient services including chemotherapy infusions, with no annual out-of-pocket maximum. A full course of chemotherapy can cost $100,000 or more, meaning your 20% share could exceed $20,000. Without a Medigap supplement plan, this exposure is unlimited. Medigap Plan G eliminates this 20% coinsurance entirely (after the Part B deductible of $257 in 2026).
Does Medicare cover cancer clinical trials?
Yes. Medicare covers routine costs for beneficiaries participating in qualifying clinical trials for cancer and other serious conditions. Routine costs include standard treatments and tests you would receive outside the trial, hospitalizations, and doctor visits. The experimental treatment itself is typically covered by the trial sponsor, not Medicare.
Can I see a specialist at Moffitt Cancer Center with Medicare?
Yes. Moffitt Cancer Center in Tampa is a Medicare-participating provider, meaning it accepts Original Medicare (Parts A and B). If you have Original Medicare with a Medigap supplement, you can see any Medicare-accepting provider nationwide, including Moffitt, without a referral. If you have a Medicare Advantage plan, you should verify that Moffitt is in-network before seeking care there.
Does Medicare Advantage cover cancer treatment differently than Original Medicare?
Medicare Advantage plans cover the same medically necessary cancer treatments as Original Medicare, but they typically impose network restrictions and may require prior authorization before treatment begins. If you are diagnosed with cancer while on an MA plan, your oncologist or cancer center must be in the plan's network to receive in-network cost sharing. Some Floridians with cancer switch back to Original Medicare plus Medigap during the Medicare Advantage Open Enrollment Period (Jan 1–Mar 31) for unrestricted specialist access.