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Lupron and Medicare Part D

Prostate Cancer | Last Active: Jul 18 1:20pm | Replies (19)

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@bluegill

I still have 6 months to figure all this out. I just chatted with a representative from medicare.gov, and he said this: "Medicare covers cancer treatment when it is medically necessary and is ordered by your doctor."

So, is Lupron a treatment or a drug or a medication?

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Replies to "I still have 6 months to figure all this out. I just chatted with a representative..."

I had my prostate removed and I have had no treatments. My wife has GBM and medicare part B covered her injections. I think ,as someone else mentioned, her Oncologist handled all the approvals. I would discuss this with them. It shouldnt be their first rodeo. I would say Lupron as an injection provided by the Dr becomes covered under part B. My wife has had 5 surgeries, Immunotherapy injections, 4 hospital stays, participated in a trial, 3 ambulance calls, and dozens of lab work, and testing. I have not had one bill.

It is classified as a treatment and therefore covered under original Medicare Part B when given in an outpatient facility or office. The Medicare.gov chat reps rarely give detailed answers. You should ask the oncologist's staff, who have undoubtedly dealt with Medicare claims like this repeatedly.