Medicare covers FDA-approved treatments for testicular cancer. It does not typically cover experimental treatments. Approved treatments can depend on your cancer stage and other factors.

Original Medicare (parts A and B) typically covers diagnosing and treating testicular cancer. However, you may have to pay a copayment or other out-of-pocket costs.

Medicare Advantage (Part C) plans must offer similar coverage to Original Medicare. Some of these plans may also provide additional benefits, though you may need to receive treatment from an in-network provider for it to be covered under your plan.

While treating testicular cancer can still be expensive if you need surgery, chemotherapy, or radiation therapy, Medicare typically covers prescribed treatment for testicular cancer, including:

  • chemotherapy
  • radiation therapy
  • surgery
  • other medications

However, Medicare does not cover experimental treatments.

Read on to learn what Medicare covers and how much you can expect to pay for testing and treatment for testicular cancer.

Testicular cancer screening is not covered as a part of Medicare’s preventive and screening services. Preventive services under Medicare typically only cover routine screenings for specific health conditions. In some instances, they’re only covered for people with a high risk of developing them.

While Medicare does not cover routine screening for testicular cancer, it will still cover testing for diagnostic purposes. This includes if you have symptoms, like a lump on your testicles, or other test results, like specific blood tests, that lead a doctor to believe you may have testicular cancer.

Medicare also covers this testing if you’ve already had testicular cancer, and doctors need to monitor the effectiveness of your treatment plan during and after treatment.

What does testing for testicular cancer cost under Medicare?

Under Original Medicare, you are responsible for 20% of the cost of testing after meeting your Medicare Part B deductible. You may have additional out-of-pocket costs if the healthcare professional or facility does not “accept assignment,” or the Medicare-approved amount for the service, or if they do not work with Medicare. So, it’s important to ask upfront.

What you pay can vary by the tests required. These tests can include:

  • ultrasound
  • blood tests
  • fine needle biopsy, which can range from $245 to $555, depending on where it is performed

Doctors may treat testicular cancer with surgery, chemotherapy, or radiation therapy. You may need one or more treatment types depending on the stage of your cancer.

Your oncologist can help you understand which treatment may be necessary if you have testicular cancer and how much you can expect to pay if you have Medicare.

Can Medicare refuse cancer treatment?

Medicare covers medically necessary treatment, including cancer treatment.

However, it only covers treatment options approved by the FDA and recommended by your treating physician. It does not cover experimental treatments, though it may cover some aspects of participation in a clinical trial.

For the most coverage, it’s best to ensure the facilities where you receive your treatment are approved by Medicare and “accept assignment,” or the Medicare-approved cost of particular services. Otherwise, you may be responsible for paying the difference between what they charge and what Medicare covers.

If you have a Medicare Advantage plan, ensure that the providers and facilities involved in your treatment are in-network. Otherwise, you may have to pay additional costs out of pocket.

The out-of-pocket cost for treating testicular cancer can vary by the specific treatments you need. These may vary by stage and can include:

  • Surgery to remove a testicle: For a simple procedure, you may pay $389 to $728, depending on whether you have the surgery in a hospital or outpatient center.
  • Surgery to remove one or more lymph nodes: The cost of lymph node removal can vary depending on which and how many lymph nodes are affected and where you have the procedure. For this procedure, you may pay between $343 and $808.
  • Radiation therapy: Medicare covers the cost of radiation therapy under Part B. You pay 20% of the cost of the service. Your cost can depend on how many sessions you require.
  • Chemotherapy: Medicare covers the cost of chemotherapy under Part B. You pay 20% of the cost of the service. Your cost can depend on how many sessions you require and the specific chemotherapy drugs you need.
  • Other medications: Part B also covers drugs you may need to treat side effects, such as nausea. You pay 20% of the cost of these medications. If you have Medicare Part D (prescription drug coverage), your Part D plan may cover these drugs.

When receiving treatment for cancer, your oncologist’s office may request pre-approval of specific medications and chemotherapy drugs from your Medicare plan. During that time, you can often find out what you’re expected to pay.

Medicare does not cover experimental treatments, though it may help pay for certain parts of clinical trials.

Your coverage also depends on whether your doctor accepts 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 who takes Medicare. If they do not, you may have to pay additional fees.

Medicare Advantage plans must provide coverage similar to Part A and Part B. Some plans may also provide prescription drug coverage, similar to a Part D plan.

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. However, you may need to visit specific in-network providers for your care.

To find out specifics about your coverage for testicular cancer testing or treatment, call your provider and speak to a representative.

Medicare Part D plans help cover prescription drug costs not covered under Part B. Most prescription medications and some chemotherapy treatments are covered under Part D.

Medications costs vary depending on the type and dosage of medication you take, your specific Part D plan, and where you get your medication from. You may have deductibles or out-of-pocket costs.

Medicare can help cover many of the costs associated with diagnosing and treating testicular cancer, though you will likely have out-of-pocket expenses.

Your costs can depend on the specific treatments you require, as well as the number of sessions of chemotherapy or radiation therapy you need, if any.

You can also check to see if you qualify for any Medicare assistance programs that may help with the costs of Medicare. A Medicare Supplement (Medigap) plan may also help pay for some out-of-pocket costs associated with your care.