Medicare Coverage for Cancer in Washington
| Medicare Part A Coverage | Yes — hospital and inpatient care |
|---|---|
| Medicare Part B Coverage | Yes — 80% after deductible |
| Medicare Part D Coverage | Yes — prescription drugs covered |
| Your Cost Share (Part B) | 20% after $240 deductible |
| Average Annual Medicare Cost (Cancer) | $58,400 |
| Medicare Beneficiaries in Washington | 1,480,000 |
Does Medicare Cover Cancer in Washington?
Yes — Medicare covers cancer treatment in Washington under both Part A (hospital/inpatient) and Part B (outpatient/physician services). The average annual Medicare cost for Cancer is approximately $58,400, with Medicare paying 80% of approved charges after the Part B deductible ($240 in 2026).
What Medicare Covers for Cancer in Washington
- chemotherapy
- radiation therapy
- surgery
- immunotherapy
- cancer screenings
- clinical trials
- hospice care
- pain management
Your Out-of-Pocket Costs for Cancer in Washington
Under Original Medicare in Washington, you pay 20% of all Part B-covered cancer services after meeting the annual deductible ($240 in 2026). There is no out-of-pocket maximum under Original Medicare, which means costs can add up significantly for serious conditions. The average Washington Medicare beneficiary with cancer pays approximately $11,680/year in out-of-pocket costs under Original Medicare.
Cost Comparison: Original Medicare vs. Medicare Advantage for Cancer in Washington
| Coverage Type | Annual Out-of-Pocket (Estimated) | Out-of-Pocket Maximum | Prescription Coverage |
|---|---|---|---|
| Original Medicare (Parts A+B) | $11,680 | No limit | Separate Part D plan required |
| Original Medicare + Medigap Plan G | $3,160 + $1,824 Medigap premiums | Effectively capped | Separate Part D plan required |
| Medicare Advantage (avg in Washington) | Varies by plan | Capped (varies) | Usually included |
Medicare Advantage Coverage for Cancer in Washington
Medicare Advantage plans in Washington must cover all services that Original Medicare covers for cancer, but may have different cost-sharing structures. With 38 MA plans available in Washington, you can compare plans specifically for their cancer coverage, including specialist networks, prior authorization requirements, and drug formularies. The average MA plan in Washington is rated 4.1 stars by CMS.
Medicare Part D Coverage for Cancer Medications in Washington
Medicare Part D covers prescription drugs used to treat cancer in Washington. In 2026, the maximum out-of-pocket cap for Part D drugs is $2100/year — a significant protection for patients with high drug costs. Washington has 24 standalone Part D plans available. Drug coverage varies by plan formulary, so compare plans at medicare.gov/plan-compare to find the best coverage for your specific medications.
Medicaid and Cancer in Washington
Washington has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage. For dual-eligible individuals in Washington with cancer, Medicaid covers Medicare cost-sharing (premiums, deductibles, and copays), providing comprehensive coverage with minimal out-of-pocket costs.
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